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How to stop transmissions
Our system processes claims very quickly—often faster than users can complete their ticket. While larger payers typically check for files on a frequent schedule, smaller payers may do so less often, so it’s always worth verifying a claim's status. ...
Updated on : 29 Oct 2024
How to Update Invoice Email Recipients in Claim.MD
Administrative users sometimes need to update their Claim.MD account settings to ensure invoices are sent to the correct email addresses. Follow the steps below to manage invoice distribution by adding the appropriate email under the "Invoices" sec...
Updated on : 15 Oct 2024
How can I delete a claim?
An archived claim that is never submitted will be categorized as 'deleted.' To archive an unsubmitted claim, navigate to the View/Edit Claim screen, and click the red Archive button. To retrieve and restore a deleted claim: ...
Updated on : 07 Oct 2024
How to handle Missing ERA
Searching for ERA in Claim.MD Prior to contacting Claim.MD to report a Missing ERA please be sure to thoroughly utilize the Claim.MD tools available concerning ERA. We recommend that you first confirm the Provider has enrolled (Prov. Enrollme...
Updated on : 13 Aug 2024
WARN: Using group NPI [XXXXXX] in the Rendering NPI field will cause the billing provider to be sent as an individual [XXXX].
These warnings inform you that the current method of entering data will not transmit to the payer as expected. To ensure X12 compliance for electronic claims: Issue: Entering the same NPI in both block 31 (rendering provider) and...
Updated on : 02 Aug 2024
Do I need to wait for ERA enrollment to complete before submitting claims?
No, claim submissions are not dependent on the completion of ERA enrollment. It is best practice to send claims immediately upon receiving enrollment confirmation from payers that require submission enrollment. For payers that do not require this, y...
Updated on : 21 Jun 2024
How can a provider re-enroll?
Re-enrollment may be necessary for various reasons, including if the original enrollment failed or was never processed, if we changed our route for the payer, or if the provider office somehow changed the route. Additionally, there are other reasons...
Updated on : 21 Jun 2024
How do I add an attachment to a claim?
Attaching files to a claim in Claim.MD Allowing Attachment Please note, not all payers or their claim submission trading partners support attachments. To search for payers that allow attachments, first click on this link to access the pa...
Updated on : 01 Nov 2024
How do I add a document to an existing support ticket?
Occasionally, adding documents such as a Member/Insured ID Card, Payer Explanation of Benefits (EOB), or similar documentation to an existing support ticket is required. This step aids in verifying Payer ID Numbers, a standard part of our procedure,...
Updated on : 16 Aug 2024
How do I delete a provider?
There are two main reasons why one might delete a provider profile: Data was entered incorrectly when initially adding the provider, such as entering the wrong NPI or Tax ID. These cannot be edited after being added originally. The provid...
Updated on : 22 Mar 2024
What are the best ways to contact Claim.MD?
Support Ticket The most efficient way to receive support from Claim.MD is to open a support ticket within the web portal. Login to your Claim.MD account and open a ticket . PHI Requests All support requests that contain Protected Health Infor...
Updated on : 19 Mar 2024
How does Claim.MD decide when to update a claim record, or create a new one?
By default our system will identify a claim as an update to a previous record if all of these values match a previous claim: pcn prov_npi prov_id payer_order proc_code (charge line field, 2400) from_date (charge line field) charge...
Updated on : 19 Mar 2024
Where can I find the Payer List?
To find the list of payers while logged into Claim.MD Click Provider Enrollment in the left navigation menu. Click on a Provider from the list. Enter the name of the Payer in the Payer Search field at the top righ...
Updated on : 26 Aug 2024
How do I submit a support ticket for a missing ERA?
To initiate a Missing ERA Support Ticket, it is crucial to first confirm your ERA enrollment with the relevant payer. Once this is verified, follow these steps: Navigate to the Support Tickets page. Click on the New Tickets button. Select ...
Updated on : 19 Mar 2024
How do I correct a professional claim?
In medical billing, a corrected claim is a resubmission of a healthcare claim with revised information to rectify errors in the original submission, ensuring accurate details for processing by the insurance payer. The following are the step...
Updated on : 02 Apr 2024
How do I void a professional claim?
At times, claims may need to be voided due to errors or discrepancies in the submitted information. In medical billing, a voided claim refers to the cancellation or annulment of a previously submitted healthcare claim. Voiding a claim is done to e...
Updated on : 02 Apr 2024
How do I correct an institutional claim?
In medical billing, a corrected claim is a resubmission of a healthcare claim with revised information to rectify errors in the original submission, ensuring accurate details for processing by the insurance payer. Navigate to the View/Edit Claim ...
Updated on : 02 Apr 2024
How do I void an institutional claim?
At times, claims may need to be voided due to errors or discrepancies in the submitted information. In medical billing, a voided claim refers to the cancellation or annulment of a previously submitted healthcare claim. Voiding a claim is done to e...
Updated on : 02 Apr 2024
How do I enroll in ERA for an NPI already associated with another account?
Move ERA for all payers to a new account If the goal is to move ERA for all payers to a new account: The provider should reach out to their billing company or the previous software provider. Instruct the provider/biller to delete the provide...
Updated on : 19 Mar 2024
How do I look at past claims?
Question : How do I look at past claims? I submitted claims over 2 weeks ago and can no longer find them on my Manage Claims. Answer : You can go to the Search page and enter the Member ID Number or the Last Name and it will pull up all cla...
Updated on : 19 Mar 2024
How can the system disregard ERA denials?
In certain cases, claims on ERA may be denied payment, but instead of appearing as a rejected claim in the Manage Claims page, they should be disregarded. This situation can occur when the denial is actually a reduction for multiple units of the sam...
Updated on : 20 Mar 2024
How do I appeal a claim?
Healthcare providers may need to make an appeal for a claim to payers for a variety of reasons. One common reason is when a claim is denied due to a coding error. This can happen when the provider has used an incorrect code for the procedure perform...
Updated on : 19 Mar 2024
How do I handle secondary claims?
Question : How do I handle a cross-over claim? Answer : You would bill the Primary Payer first, then check the primary payer's EOB/ERA and verify that they have not already forwarded the claim to the secondary payer. Question : What if I...
Updated on : 01 Oct 2024
How do I allow claims to be transmitted automatically without approval?
While it is strongly advised to maintain the default setting of "Transmit Approval Required" during the initial weeks of using Claim.MD, certain providers or entities may prefer to immediately send their claims to the payers without having to review...
Updated on : 19 Mar 2024
How can I cancel a Claim.MD account?
IMPORTANT! Cancellation of accounts can only be completed by logging into the account and requesting the cancellation online. Cancellations are not accepted via phone or email. To cancel a Claim.MD account, follow these steps: L...
Updated on : 19 Mar 2024
How do I create, modify, delete, and use a claim template?
Templates can be created and utilized in the View / Edit claim screen to save time when entering repetitive provider data directly into the system. Creating a Claim Template To create a new template, the first step is create a new bla...
Updated on : 19 Mar 2024
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