For Canada users, in the Manage Module, click Send Claims.
Canadian insurance claims can be managed on the Insurance Claims window. Claims cannot be sent as a batch in Canada.
For a full description of all buttons and columns, see Send Claims. Below is detail on features specific to Canada.
Toolbar
Toolbar options:
- Outstanding: Request outstanding transactions (ROT) from the default clearinghouse. See Retrieve Reports below.
- Payment Rec: Get payment reconciliation transactions for a specific carrier, billing and treating provider. This report is not used often.
Retrieve Reports (ROT - Request Outstanding Transactions)
Users are alerted of outstanding transactions (mailbox items) when sending claims. Retrieving them is optional and does not affect patient accounts.
Click Outstanding to retrieve reports.
If a user is notified of outstanding transactions upon sending a claim, and would like to retrieve them, they should use these options (in any order):
- Version 4: Selected by default. Sends the ROT (04) request to recently used carriers.
- Version 4 To Specific Carrier: Select this option, a carrier from the list and the appropriate Office Number, then click OK. Useful when retrieving mailbox items immediately after receiving the notification (select the most recent carrier that a claim was sent to).
Note: Mailbox items might be automatically retrieved for multiple carriers at a time (others on the same network as the selected carrier) and oftentimes only a single request is necessary to download all mailbox items.
Wait for responses to show. When each step is complete, a dialog with the word Done shows.
History
Undo: Changes a sent claim status to
Waiting to Send.
- Does not reverse sent claims. See Reversals section in Canada Claims for more information.
- A record of sent or printed claims are available in the History grid. Double-click a row to view sent and received information.