Bill Insurance

PCC's insurance billing tools help you submit claims in just a few minutes. You can review claim problems quickly and easily, make corrections and resubmit claims, and then review rejections using clear, straightforward tools.

Read the Submit Claims procedure below to learn how to send out claims. Then read further to learn more about how to work down your insurance accounts receivable.

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  • Submit Claims

    Follow this procedure to prepare and send claims.
  • Insurance Billing Overview

    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.

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  • CARC Values in Partner

    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.
  • What is a Claim ID Number?

    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.
  • Print Paper HCFA Claim Forms

    Hopefully most of your claims are submitted electronically. Some claims must still be printed on paper, however. The procedure above provides the basics. This section describes additional details and options in the hcfa program.
  • The Claim Journey Explained

    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.
  • Accounting Challenges

    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."
  • Configure PCC EHR Billing and the Electronic Encounter Form

    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.
  • Send Attachment Codes on PCC Claims

    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.
  • Review EDI Reports
    • Review an Electronic Remittance Advice (ERA)

      An ERA is an electronic version of the traditional EOB. Instead of receiving a printed, paper explanation of payments and adjustments, an ERA arrives electronically and payment is sent separately or deposited directly into your practice's bank account. ERAs appear along with other reports on the main EDI Reports (ecsreports) screen.
    • EDI Report Glossary

      This glossary includes definitions and examples of several important EDI Reports. As always, feel free to contact PCC Support at 1-800-722-1082 if you have any questions or need help understanding EDI reports.
    • Which EDI Reports Should You Review?

      PCC, claim clearinghouses, and carriers all send EDI reports. How do you know which reports are important to review, and which reports are merely for reference purposes?
    • Introduction to EDI Reports

      Your office receives many different electronic reports related to claims or other electronic submissions. These include:
    • ERA Reports

      The ERA Reports program (erareports) lists remittance advice that insurance carriers sent to your office. As soon as Partner receives an electronic EOB from a carrier, it reads the file and creates "check" files, which can be viewed on the main screen in erareports.
    • Use the EDI Reports Program

      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.
    • Read EDI Reports

      Training Video
  • Track and Work on Outstanding Claims
    • Insaging: The A/R Summary Report

      The insaging report shows you an aged summary of your practice's outstanding charges broken down by insurance group. It is a helpful collection tool that can show you which carriers owe you the most money and how old those balances are. The insaging report is also a quick way to see your total A/R, and it will help you determine which insurance carriers need follow-up attention.
    • Inscoar: The Claim Work-Desk

      The inscoar report provides a detailed charge-by-charge accounts receivable for your insurance companies. You can use inscoar to find insurance charges that have not been paid and to work down old, overdue charges. In addition, interactive inscoar is a great work environment from which you can research billing history, make changes, and resubmit claims.
    • Interactive Inscoar

      In addition to reading the inscoar report and using it to call insurance companies, you can perform a wide range of functions while viewing inscoar. You can research account history, correct and resubmit problem claims, and add notes to the patient or account. These features and more are available through the Interactive Screen inscoar output.
    • Track and Work on Outstanding Claims

      Insurance claims are not always paid, and insurance carriers do not always send you an explanation. Therefore, you need tools to track and work-down your outstanding claims. The topics below explain Partner's tools for claim work.
  • Resubmit Claims
    • Selecting Criteria for Re-batching Claims

      maketags can find and rebatch charges by a wide range of criteria, including age, balance and insurance status, insurance plan, and provider. Read below to learn more about the different criteria you can select from the first screen in maketags.
    • Resubmit Claims Introduction

      You can rebatch and print any single claim, for any charge or visit, from the Correct Mistakes (oops) program. Sometimes, however, you need to resubmit all of the claims for a certain insurance group, a specific date range, or all of the claims containing a certain procedure. Resubmit HCFA Forms (maketags) is a program that finds and re-batches large groups of unpaid or paid claims.
    • Resubmit a Claim

      Follow the procedure below to resubmit a single insurance claim.
    • Print Claims Directly from the maketags Program

      Under unusual circumstances, you may need to force a batch of claims to print without processing them.
    • Quickstart: Resubmit Claims with maketags

      You can run maketags and resubmit large batches of charges quickly and easily. Follow the procedure below and read the other sections to learn more.
    • Use SRS to Find and Rebatch Claims

      Have you ever needed to resubmit all claims with a certain procedure, place of service, or for accounts with a specific status flag? Use maketags's Smart Report Suite (srs) features to create custom restrictions specifying which charges you would like to rebatch.
    • Send Attachment Codes on PCC Claims

      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.