Paper Claims

Paper Claims
This chapter has the following topics:

Setting a claim to print on paper
Printing a claim form NOW
Reprint or rebatching claims

Note: Before you do any printing of claim forms, you need to align your forms. Each printer is different. Please read the Claims Printing chapter to learn how.

Setting a claim to print on paper
When a claim is first created it is by default assigned to paper claim printing. It is the insurance company then assigned to that claim that determines if it will still be printed on paper (ECS# of 0) or sent electronically (ECS# of 1 or higher). You can see what the status of Paper Claim processining is by looking at the lower section of the Charge Entry screen when an invoice is first created.

A claim will be printed on a claim form in the next Batch Printing when the following happens (most of which happens by default and only the operator can change them).

The Billing Date (also called ...As of) is today or earlier (if this date is set into the future on purpose, the claim will not be processed but will appear on your Aging report. This comes in handy with Medicare patients in the beigginning of the year where you do not want to collect their deductibles)
The Claims field says "Batch", as it does above
The ECS# is 0 (zero), as it does above
The Form Type associated with the insurance is not 0 (zero) which means it will print on a claim form.

Therefore, once you leave the charge screen, and you have made no changes to any of these fields, the claim will be printed in the next batch!

Printing a claim form NOW
If you want to take action on this invoice NOW, you have two options..

Clicking Send to Printing sends this invoice to the Claims Printing module for printing in the current batch already there. You would use this option, let's say, if you forget to process this invoice but already clicked Batch Paper Claims on the Main Menu
Clicking the other button, here labeled HCFA fill-in prints the invoice on its default claim form now.

Batch Paper Claims
This topic is covered in the Claims Printing Module chapter.

Resubmitting CLaims (paper or electronic)
If an insurance claim needs to be sent out in the next batch of claims(regardless of whether its paper or electronic), select Batch from the pop-up menu next to Claim Processing. Here it says Hold.

The software can be set up to automatically send a claim when the invoice is assigned to the secondary or tertiary insurance. This setup is done in the Billing Info section in the Insurance’s database. You would select Auto-Bill as “Y” and then when an invoice is assigned to that particular insurance a claim would be processed and Batch would be entered for you. If the insurance is able to accept secondary payment information electronically (most do NOT) then you would select ECS If Sec as “Y”! (Boy this software does a lot!)

If a claim is on Hold for some reason (like you talked to the carrier and the check is in the mail...yeh, right!) then select Hold instead. Also, if the patient has been put into collections then you should set the claim to Collect.

If you need to print this claim NOW, and you have the correct form in your printer, click on the form name button (in this case HCFA fill-in) and confirm your action at the dialog seen immediately below. However, if the claim is assigned to the patient, an insurance claim cannot be printed and the second dialog appears.

If you need to send a claim NOW for processing with the current batch in Claims Printing, click Add to Batch and the claim will be sent to Claims Printing for later printing. If the invoice is already in Claims Printing you will be a dialog warning you of this!

Note: Each time a claim is printed or batched, today’s date will be placed at the top of the Print Date(s) field. Also, every time a claim is sent ECS today’s date is added to the top of ECS Date(s) field!

last updated 9/15/2004