Submit Claims
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Submit Claims (8 minutes • 2022-11)
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Learn how to submit claims with PCC.
Related Articles
- Here are some related articles in Billing and Practice Management > Bill Insurance:
- Learn how to submit claims in PCC EHR or in the previous Practice Management tool.
- When insurance carriers send payment and adjustment information, either on an EOB or an ERA, they often include a code with a small message. These codes are known as CARC values, or Claim Adjustment Reason Codes, and they are an industry-wide standard.
- Every insurance claim in Partner has a unique identification number. The number appears in various Partner reports and programs, and you can use it to improve claim tracking and payment posting.
- Partner's insurance billing tools help submit claims, review rejections, and work down your insurance accounts receivable. Partner helps you maximize the use of your time as you pursue proper insurance reimbursement.
- You can review and confirm patient insurance eligibility in either PCC EHR or in the Partner practice management system. This article teaches you how to use Partner's eligibility program to review status for upcoming appointments.
- While most claims are transmitted to payors electronically, sometimes you may need to generate a paper 1500 HCFA form.
- How is a claim created, and what happens in the background to make sure your practice is paid? Read below to learn some of the "under the hood" workings of claims after you post charges into PCC EHR.
Check Patient Insurance Eligibility
PCC automatically checks insurance eligibility for all of a scheduled patient's active insurance plans, if the carriers support automated eligibility. You can use eligibility features in PCC to review and confirm eligibility for upcoming appointments. You can also review and re-check a patient's insurance eligibility status during Patient Check-In.Prepare an Encounter for Billing
Learn how to review and link diagnoses and procedures and make a visit ready for billing in PCC EHR.- The medical biller's job would be easier if accounts paid on time and insurance companies reimbursed the correct amount. Unfortunately, accounts build up balances and credits and insurance companies overpay, underpay, and demand "takebacks."
Review What Was Billed for an Encounter
After you bill a visit in PCC EHR, you can return to the patient chart and review what was sent to thecheckout
program.Configure Procedure and Diagnosis Billing in PCC EHR
Use the Billing Configuration tool to configure billing behaviors of procedures and diagnoses and the Billing screen in PCC EHR. Follow the procedures below to open the Billing Configuration tool and make changes.Bill for Phone Notes and Portal Messages
Your practice can bill for phone calls and portal messages. Read this article to learn how to chart and bill for a phone encounter (or portal message thread). You'll also find configuration instructions and tips for turning phone calls and portal messages into billable telemedicine encounters.Review Policies in Practice Management and Add an Insurance Plan to Your System
This is a placeholder for the article excerpt, a one or two sentence summary.Reconcile Payments and “Prove Out” at the End of the Day
You can quickly and easily reconcile payments that your practice has posted in PCC EHR. Run the Payment Reconciliation report in order to prove out, checking against your cash drawer and records at the end of the day or the end of your shift. Open the Payment Reconciliation report from the Report Library in PCC […]- As you post charges, you can review and update patient information (like insurance eligibility), double-check the linking and codes that the clinician selected, and post any payments received.
- Watch this video to learn how to review encounter information and post charges for an appointment in PCC EHR.
Schedule, Chart, and Bill a Telemedicine Visit
Learn how to schedule, chart and bill a telemedicine visit with PCC.Bill for Phone Encounters and Portal Messages
After you complete a phone note or portal message thread in PCC EHR, you can bill for the encounter right in PCC EHR.Schedule, Chart, and Bill a Telemedicine Encounter
Schedule a telemedicine appointment with optional video connection information and then chart and bill the visit using PCC EHR. Patients and families will see telemedicine information in the portal, and billers will have everything they need to post charges and queue up a claim.Configure Post Charges in PCC EHR
Read this article to learn about configuration options and implementation recommendations for the Post Charges features in PCC EHR.Post Administrative Fees Without an Appointment
Learn how to post a forms fee or any other administrative charge that could occur outside the context of an appointment.- Read this procedure to learn how to create a hospital encounter on a patient's chart, post hospital diagnoses and charges, adjust claim information, and queue up a claim.
Work with a Patient’s Billing History in the Chart
You can review all of a patient's billable encounters in the Billing History section of a patient's chart.- Learn how to post a forms fee or any other administrative charge that could occur outside the context of an appointment.
Work with a Patient’s Billing History in the Chart
You can review all of a patient's billable encounters in the Billing History section of a patient's chart.- Learn how to post charges for a hospital encounter in PCC EHR.
- Use this new user training outline to learn how to complete billing tasks in PCC.
Post Personal Payments and Write Off Charges
Watch this video to learn how to post any personal payment in PCC EHR. Along the way, learn about Account Notes and bad debt write-offs.Insurance Billing (Advanced Training Session)
Watch this video to learn insurance billing workflows for configuration, claim review, and reporting.Configure Your Telemedicine Place of Service Codes (2022)
Learn about CMS's changes to Place of Service (POS) codes for telemedicine (telehealth), and learn options for adjusting your configuration in PCC EHR so you can schedule and bill for telemedicine encounters quickly and easily.- Watch this video to learn how to use the Claim Holds tool to hold back claims for specific dates of service, billing providers, locations, and insurance plans.
Hold Claims for Specific Dates of Service, Billing Providers, Locations, and Plans
When your practice needs to prevent certain claims from being submitted, you can create a claim hold. A claim hold prevents claims from going out for specific dates of service, billing providers, places of service, and insurance plans.Review Payment History and Edit Personal Payments
You can review payment history by encounter, or see all payment history for an account. You can also edit personal payments that were posted incorrectly, or that are linked to the wrong charges.Review Payment History and Edit Personal Payments
You can review payment history by encounter, or see all payment history for an account. You can also edit personal payments that were posted incorrectly, or that are linked to the wrong charges.- You can print a receipt whenever you post a payment. You can also print a receipt for any payment(s) in an account's history.
- You can print a receipt whenever you post a payment. You can also print a receipt for any payment(s) in an account’s history.
Post a Returned Check or Other Payment Reversal
Learn how to post a returned check, stopped credit card payment, or other payment reversal in PCC EHR.Work on Claim Errors and Rejections
After you prepare and submit claims, you must deal with claims that could not be submitted or were rejected.