Submit Claims
After your practice submits claims, you must address claims that could not be submitted, post incoming adjudication that appears on ERAs and EOBs, and followup on unpaid claims. While many of these functions are performed in PCC EHR, a few of these tools still utilize the previous Practice Management interface.
Training Videos
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Prepare and submit claims. Then work on any claims that were stuck and couldn't be submitted. -
Configure Claim Holds and Claim Delay
Watch this video to learn how to hold claims for specific providers, locations, or plans and how to configure your practice's claim delay. -
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. -
Insurance Billing (Advanced Training Session)
Watch this video to learn insurance billing workflows for configuration, claim review, and reporting. -
When you need to review the insurance company's full response to a claim submission, how do you open and work with the ERA 835 file in PCC?
Get Started
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Use the Claims tool to process and submit claims to insurance companies and other payers, work on claims that could not be submitted, and review a log of submissions.
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PCC's insurance billing tools help you process and prepare claims, send them electronically or print them, review rejections and denials, fix problems and resubmit, and work down your insurance accounts receivable. You can maximize the use of your time as you pursue proper insurance reimbursement.
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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.
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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.
Learn More
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Follow Up on Unpaid Claims and Insurance A/R
You can use PCC's tools to work on claims with errors, rejections, and denials. But what if a problem is fixed, but the claim wasn't resubmitted? Or what if an insurance payor simply never responds? Are some insurance payers regularly failing to pay you in a timely fashion? You may need specialized tools to track and work down your practice’s insurance A/R. -
While most claims are transmitted to payors electronically, sometimes you may need to generate a paper 1500 HCFA form.
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Hold Claims or Delay All Claims
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. You can also configure your practice’s claim delay, which prevents any claim from going out until a certain number of days after the date of service. -
Claim Error Needs Correction Reference
What kinds of pre-submission processing does your PCC system do on claims? What errors can it find, and how do you fix them? - Review EDI Reports
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Your practices receives many different electronic responses to claim submissions and billing. Read this article to learn the different EDI responses, which responses require attention, and how to use PCC's tools to review and respond.
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The EDI Reports (
ecsreports
) program stores and displays claim and transmission related messages and reports. You can quickly search, review, and print the reports, as well as track which reports you have printed in the past.
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- Resubmit Claims
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Create New Claims and Resubmit (maketags)
Use Resubmit Claim Forms (maketags) to find and rebatch large groups of claims based on customizable criteria. -
Add an Attachment Code to a Claim
If a secondary insurance requires the EOB from the primary, or any claim requires a certificate of medical necessity, discharge summary, or other clinical documentation, you can add attachment codes to a visit’s charges, generate a unique attachment ID, and specify the attachment type and method. -
Correct a Claim: How to Fix and Resubmit an Insurance Claim
When you receive a rejection, or you have a claim or billing problem, how do you correct the encounter information and then resubmit the corrected claim? Read this article to learn how to update and resubmit a claim. -
Change an Encounter’s Billing Place of Service After Posting Charges
You can adjust an encounter’s place of service when you Post Charges in PCC EHR. Sometimes you need to change the billing place of service of an encounter after the charges have already been posted. Read below to learn how to change the billing place of service of a phone note, portal message, or visit […] -
Create New Claims and Resubmit
Training Video
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