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eClaims Ability Quick Start Guide

Overview
This page will outline the basics of the eClaims Ability. Each sidebar item has its own buttons, panels, and fields associated to it. The buttons, panels, and fields associated to a given sidebar item will be laid out under that specific sidebar item. Since each item contains important information, clicking on the item in this document will link to a page with more information regarding that item.

Layout
This is a breakdown of the nodes in the sidebar of the eClaims Ability and the elements in the main eClaims window that appear when each node is selected.

eClaims Node
This node brings the user to a view that allows them to work directly with the electronic claims that have been created, sent, and paid.

  • Send Button
    This button allows the user to transmit electronic claims directly to our partner clearinghouses from the Ready Bin, or generate a .CLM file for manual upload to non-partner clearinghouses.
  • Rebuild Button
    This button allows the user to update new information in selected eClaims.
  • ‘Move To’ Menu
    This drop-down menu allows the user to manually move claims from one bin to another without transmitting the claim or updating new information on the claims.
  • Invalid Tab
    This tab shows the contents of the Invalid Bin. eClaims are moved to this bin automatically to prevent erroneously sending claims that are missing necessary information.
  • Ready Tab
    This tab shows the contents of the Ready Bin. eClaims are placed in this bin at the time they are created. Claims in this bin are ready to be sent.
  • Sent Tab
    This tab shows the contents of the Sent Bin. eClaims are moved to this bin automatically once the claim has been transmitted to a partner clearinghouse or the .CLM file has been generated for manual upload to a non-partner clearinghouse.
  • Rejected Tab
    This tab shows the contents of the Rejected Bin. Certain partner clearinghouses will send back reports on sent eClaims. When a report shows a claim as not being accepted by the clearinghouse or payer, MacPractice will automatically move the claim to the Rejected Bin.
  • Accepted Tab
    This tab shows the contents of the Accepted Bin. Certain partner clearinghouses will send back reports on sent eClaims. When a report shows a claim as being accepted by the clearinghouse or payer, MacPractice will automatically move the claim to the Accepted Bin.
  • Paid/Closed Tab
    This tab shows the contents of the Paid/Closed Bin. Once a user has applied payment to all procedures on an eClaim, MacPractice will automatically move the claim to the Paid/Closed Bin.
  • Archived Tab
    This tab shows the contents of the Archived Bin. This bin is for the purpose of moving eClaims that no longer need to be considered for payment or rework.

Reports Node
Selecting this node brings up the Reports screen and allows the user to view and interact with eClaim reports. Clicking on the triangle to the left of the node reveals all received eClaim reports that have not been archived.

  • Receive Button
    Clicking this button initiates a search for new reports and ERAs from partner clearinghouses. It will also pull in any properly formatted reports and ERA files that have been manually dropped into the Claim Templates Folder.
  • Archive Button
    This allows the user to remove reports from the Reports Node.
  • Unarchive Button
    This allows the user to select reports to restore to the Reports Node.
  • 'Template To Receive From' Drop-down
    This drop-down menu allows the user to download reports only for the specified template when an office uses more than one template for eClaim sending.
  • 'Creation Date' Field
    This field displays the date that a selected report was generated by the clearinghouse or payer.

Template Values Node
Twist this node down to view all templates that have been installed into the eClaims Ability. The user needs to select a template in order to interact with the Template Values Window.

  • 'Username' Field
    For offices that send eClaims through a partner clearinghouse, enter the username that was assigned by the clearinghouse into this field.
  • 'Password' Field
    For offices that send eClaims through a partner clearinghouse, enter the password for claim submission into this field.
  • Change Password Button
    This button is a hold over from an older version of MacPractice, and doesn't serve any viable function for users of current MacPractice builds.
  • 'Use SFTP' Checkbox
    This box must be checked for all offices that submit to partner clearinghouses. It forces MacPractice to transmit over a secure file transfer protocol.
  • 'Name' Field
    This field contains the name of the selected template. The user can enter a new name for the template into this field.
  • Version Indicator
    This displays the version of the selected template. Click the version number to view release notes for the selected template.
  • Clear Values Button
    Pressing this button will clear out all saved values in the Override Values and Default Values from the respective panels, all at once. Override and Default Values can only be modified, added, or removed by a MacPractice EDI specialist.
  • Override Values Panel
    This section of the Template Values Window contains the saved information for eClaims that will populate every single eClaim that is created on the selected template. Override and Default Values can only be modified, added, or removed by a MacPractice EDI specialist.
  • Default Values Panel
    This section of the Template Values Window contains the saved information for eClaims, created on the selected template, that will only populate an eClaim if there is not a value to pull from within MacPractice. Override and Default Values can only be modified, added, or removed by a MacPractice EDI specialist.
  • Clear Buttons
    Each node and each item within the node has a Clear button. This is used to clear out the information of the selected node or item. Override and Default Values can only be modified, added, or removed by a MacPractice EDI specialist.
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