eClaims Usage Guide - Reports Node

This guide will give a rundown of day to day use of Reports within the eClaims Ability and the elements within, with explanations of item functions and details of how to use each element within the Reports Node.

Reports Node

In order to interact directly with eClaim reports, the user must have the Reports Node selected within the sidebar of the eClaims Ability.

There usually isn't much need to work within the Reports Node on a daily basis, since reports tie directly to the eClaim with which they are associated. The results of each report is visible in the eClaim Status Panel of the associated claim. However, at some point there may be a need to view reports directly, apart from what is viewable while in the eClaims Node.

The following elements within the Reports Node are used to interact directly with the eClaim reports. Their descriptions are described below:

Reports Node - Twisted Down

If unarchived eClaim reports are present in MacPractice, a triangle will be visible next to the Reports Node, in the sidebar. Clicking on this triangle will expand the contents of the Reports Node, making them viewable to the user.

If the user clicks on the individual report within the node, the contents of that report will be viewable for the user.

Note that it is difficult to determine which report belongs to which claims, as there will be nothing in the file names of reports to indicate this. If the user wants to view claim reports for a specific patient, from within the Reports Node, the user can type the patient's name in the search bar. This will bring all reports that contain information for that patient's claims. Keep in mind that most reports contain status information of multiple claims, for multiple patients. Even when the report comes up that contains the desired patient's information, the user will most likely need to scroll through the report to find that specific patient's claim status information.

Receive Button

The Receive Button is used to manually receive reports. When there are no claims that can be sent, but there are claims in Sent that are awaiting reports, the user can select the Reports Node in the sidebar and click the Receive Button. This will force MacPractice to send a request to the partner clearinghouse, Change Healthcare, to download any outstanding reports. This will also receive any ERAs that are awaiting download from the office.

After the user clicks the Receive Button, while MacPractice is retrieving reports from the clearinghouse, MacPractice will be unusable for a short time. During this time, the bottom frame of the eClaims window will state "Receiving report data. Please wait...". Once MacPractice has downloaded all available reports, a Transfer Results Window will appear.

The Transfer Results Window will list the names of all reports and all ERAs that have been received during this Receive Reports session. It will also note how many claims have been moved to the Accepted Bin and how many have been moved to the Rejected Bin. If a multiple reports come in for a single claim, every time a different report affects that claim, it will be counted in the number of claims affected.

For example: if a claim was accepted by the clearinghouse and rejected by the payer, but nobody has received reports in a while, the clearinghouse rejection will first apply to the claim, then the payer rejection will apply to the claim. The Transfer Results Window will note that 1 claim has been moved to accepted and 1 claim has been moved to rejected. It appears in the window that two claims have been moved, but in fact it was the same claim, which has been affected twice in the same Receive Reports session. The same can happen if multiple Accepted or Rejected responses come in for the same claim.

If the user clicks OK, the window will disappear.

If ERAs have come in during the Receive Reports session, the Print ERAs Button will be usable at this time. If no ERAs were received, the Print ERAs Button will be grayed out. Clicking this button will bring down a print window.

The Print Window will offer several options to the user. Select the options in this window that will work best for the office's needs.

Archive Button

eClaim reports cannot be deleted from MacPractice. They can only be archived. The Archive Button allows the user to archive older reports. Archiving does not untie the reports from their associated claims. It only removes the reports from the Reports Node.

The user can twist down the Reports Node and select each report individually and press the Archive Button. There will be no prompt or warning when reports are archived this way. The report will simply disappear from the Reports Node. Only one report at a time can be archived by this method.

If the user highlights the Reports Node itself and presses the Archive Button, a sheet will drop down. In this sheet, the user needs only to simply check the box next to the items they wish to archive. Clicking "Check all rows" will place a checkmark next to every item in the sheet. Once all desired items are checked, the user can then press the Archive Button. This will archive all records that were selected in the sheet.

Unarchive Button

Reports that have been archived can be retrieved, by using the Unarchive Button. To unarchive reports, simply press the Unarchive Button.

After the Unarchive Button is pressed, a sheet will drop down, containing a list of all archived reports. From here, the user can check the box next to the reports they wish to retrieve, or they can opt to select all of the items in the sheet by clicking the "check all rows" box at the bottom of the sheet. Once all desired reports are checked, the user need only press the Retrieve Button at the bottom of the sheet. This will return all selected reports to the Reports Node in the eClaims Ability.

'Template To Receive From' Pop-up Menu

Some offices have more than one ProxyMed template. This is the template that is used for Change Healthcare claims. The template can be renamed, often renamed for specific doctors, to keep their claim submissions separated.

If a user wishes to only download reports that tie to a specific eClaims template, the user can click on the 'Template To Receive From' menu and select just that template. When the user clicks Receive, reports for other templates will not download into the MacPractice system.

If the menu is left set at 'None', reports for all templates will be downloaded when the user receives reports.

Creation Date

When a user selects a report within the Reports Node, the Creation Date Field will show the date and time that the selected report was downloaded into MacPractice. This does not reflect the date that the payer or clearinghouse created the report. That date is viewable within the report directly, as the first item listed in a claim report.

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