Before submitting EDI claims, the correct Insurance details should be entered for the concerned Insurance Company.

1. Click on Master Setup module and choose Insurance from the index. In the page that appears,  search for the Insurance company for which you want to set up EDI claim submission.

EDI 1

2. Ensure that the following options are entered correctly in the Insurance Company page.

EDI 2

a) Ensure that the appropriate Payer Id is given for the insurance.
b) Billing Method should be set to EDI, if the claims are being sent as EDI for this payer.
c) EMC Receiver# field should be set to your Clearing house (for e.g. if your Clearing house is Medavant, the EMC Receiver# field should be set to Medavant).

3. In the Insurance plan page, the Plan type box needs to be set appropriately. Usually for Medicare and Blue Cross/Blue Shield plans we need to set this field as Medicare and Blue Cross/Blue Shield respectively.

EDI 3

 

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