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2010 UBO/UBU Annual Educational Conference. Turning Knowledge Into Action. E-Billing for Beginners (Hands-On Training) 22-25 March 2010. Planned Systems International (PSI) , Defense Health Services System (DHSS), Relay Health. 1. Processing Claims Electronically.

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2010 UBO/UBU Annual Educational Conference

Turning Knowledge Into Action

E-Billing for Beginners (Hands-On Training)22-25 March 2010

Planned Systems International (PSI), Defense Health Services System (DHSS), Relay Health

1 processing claims electronically
1. Processing Claims Electronically

RejectedCorrect errors and validate claims

TPOCSClaimsTransmitted

ePremisClaims run thru Edit Masters

Submit

AcceptedClaim has no errors

Clearinghouse

Released

837 fileAuto Agent

Payer

Initial response is made by the payer if claim has been accepted or rejected.

*Unreleased:Claims that are in ePremis and haven’t been sent to the Clearinghouse.

Payer

Payer

E-Billing for Beginners (Hands-On Training)

2 functionalities in epremis
2. Functionalities in ePremis
  • Log-On Page
  • Home Page
  • View/Modify Claims Page (Claim Filter)
  • Claim Display Page

E-Billing for Beginners (Hands-On Training)

2 functionalities in epremis4
2. Functionalities in ePremis
  • Values for Quick Claim Filter:,“And” : “Through” (Range)

E-Billing for Beginners (Hands-On Training)

2 functionalities in epremis5
2. Functionalities in ePremis
  • Billing Type:- Primary (A) - Secondary (B)- Tertiary (C)
  • Claim Status:- Accepted- Rejected- Warning
  • Transmit Type:- Electronic- Paper- Locally Print

E-Billing for Beginners (Hands-On Training)

2 functionalities in epremis6
2. Functionalities in ePremis
  • LOB (Line of Business)1 – Medicaid2 – Medicare3 – BCBS4 – CHAMPUS/CHAMPVA5 – Commercial

E-Billing for Beginners (Hands-On Training)