Account Settings
- 19 Mar 2024
- 5 Minutes to read
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Account Settings
- Updated on 19 Mar 2024
- 5 Minutes to read
- Print
- DarkLight
- PDF
Article Summary
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Account Settings is where system-wide changes are made.
More Information
Only an Administrative User can access the Account Settings page.
Claims Settings
Please read the descriptions next to each checkbox.
| Claims Settings | |
|---|---|
| Claim Types | Select the claim types you will be submitting. This setting will affect the enrollment options available on the Create Claim menu and Provider Enrollment menu.
|
| Transmit Approval Required | Require approval before transmitting claims. If not checked, valid claims will be marked for transmit immediately.
|
| Automatic Corrected Claims | When a claim is resubmitted and the payer has returned a claim ID on the original submission, Claim.MD will automatically mark the claim as a corrected claim using the previously received payer claim ID (ICN #). |
| Enable NCCI Edits | National Correct Coding Initiative Edits. These extra edits will help identify procedure combinations that should not be billed together, procedures that require modifiers, and medically unlikely units.
 |
Electronic Remittance Advice (ERA)
This section changes settings relating to sending, receiving, and viewing ERAs from the payer.
| Electronic Remittance Advice (ERA) | |
|---|---|
| Reject Denials | Have Claim.MD create claim rejections for claims that receive ERA with no payment. Claim rejections will show in Manage Claims and claim status files (277, CSV, XML) |
| Reject Denials - Ignore Codes | Denied claims with adjustment codes not listed here will be rejected. Use this to prevent creating rejections for non paying claims, when the lack of payment is due to contractual adjustment, copay, etc. |
| ERA PDF (835) Format | When 835 files are downloaded for auto posting should Claim.MD auto upgrade them to 5010 or downgrade to the 4010 format. |
| ERA PDF Sorting | Printable version of ERA's are sorted in this order. Default will sort ERA's by the order the payer returns them. |
| 835 File Extension | Downloaded 835 files will default to an extension of ".x12". Select a custom file extension here. Examples ("835","dat","txt"). |
Claim Alerts
This section is for settings related to claim and ERA alerts.
| Claim Alerts | |
|---|---|
| Alert On | Alert on claims missing responses or ERA.  Example Response Alert in the Manage Claims page
|
| Missing ERA Days | The number of days to wait after the last submission of the claim before creating a Missing ERA alert.
Example ERA Alert in the Manage Claims page |
SFTP Settings
Important
This section is only required if using SFTP to send claims and/or receive ERA.
This section is where to configure SFTP settings. SFTP means Secure File Transfer Protocol. This is a way to transfer files automatically between systems so that uploads do not have to be manually uploaded or entered.
- Select SFTP Active YES
- Click and a pop-up box will display on the screen.
More Information
Some PMS and billing systems may ask for an MD5 Fingerprint to validate that their system is in fact connecting with the Claim.MD server. This fingerprint is located at the bottom of the SFTP credential pop-up (see image below).
More Information
We recommend copying and pasting the information, save it securely on your drive (or securely send it to the support contact person). It is important to protect these credentials as it is protecting PHI.
| SFTP Settings | |
|---|---|
| SFTP Active | Control if SFTP connectivity is active for your account. |
| SFTP Username | Username credential for SFTP connection. This is auto configured. |
| SFTP Password | Password for SFTP connection. This is visible only once, reset the password if you do not have the current one. |
| SFTP Host | This is the hostname to configure in your SFTP client. |
| SFTP Port | This is the SSH/SFTP port to configure in your SFTP client. |
| Send Files Folder | This is the folder your SFTP client should use to upload claim and eligibility files into CLAIM.MD. |
| Receive Files Folder | This is the folder your SFTP client should use to download claim status, ERA and other files from CLAIM.MD. |
| File Acknowledgment | Available file level acknowledgement formats to download via the SFTP server. |
| Claim Status Format | Available claim status formats to download via the SFTP server. |
| Receive ERA/835 | Will your software download Electronic Remittance Advice (ERA) from the SFTP server. |
| TaxID Subfolders | Separate claim status and ERA files into sub folders by Tax ID. i.e. /ReceiveFiles/741111111/60054_1234567893_11741672.835. *Your software must be properly configured if you activate this setting. |
| Invoicing | List of email addresses to send copies of invoices to. For multiple email addresses separate each with a new line. You may want to send this information to an accounting or other department. |
API
File transfer to a Practice Management System or other software can also be accomplished using the API. Users have the ability to generate their own API Account Key, which must be obtained, copied, and entered into the desired Practice Management System.
Please note that opening a support ticket is no longer necessary to enable the API Account Key section in Account Settings. The user can now generate an API Key on their own (see steps below).
To generate this key:
- Scroll down to the the API Key (Account Key) section of the Settings > Account Settings tab, click the button (see image below).
- Enter the same Claim.MD password used to login to the Claim.MD system. Click button.
- The API will display. if needed. copy the API Key using the clipboard icon to transfer it to the Practice Management System or other system.
Ensuring proper handling and security of this password is crucial.
To Delete an API Key:
If the API Key is lost, the current one will have to be deleted and another one would have to be generated and entered into the PMS or other software system.
- In Settings > Account Settings, scroll down to the API Key (Account Key) section and click the button.
- Enter your Claim.MD account password and select the button.
- The window should display Success-Removed API Key. Close this window.
- Scroll back down to the API Key (Account Key) section and the button is now available if a new API Key needs to be created (see steps above).
API Documentation
For full instructions on API related configuration, refer to this API documentation.
Modifying Vendor Access Settings
If you don't have full access to an account but require full access for various administrative actions (such as looking up claims and creating support tickets for that account), contact the account holder with administrator privileges so that they can modify the access level granted to vendors. This modification can be made at any time, enabling vendors to view specific data or settings, after which it can be reverted back to its original state.
The account holder with administrator privileges must do the following steps to change access settings for the vendor:
- In the Settings > Accounts Settings tab Scroll down to the Vendor Settings section.
- Change the Vendor Accessdropdown to the preferred setting (i.e., Full Access if giving the vendor full access to account information/configuration).
- No Access: Vendor has no access to claim data or support tickets, and Claim.MD will not include this vendor in support issues.
- Limited Access: Vendor has no access to claim data or support tickets unless assistance is directly requested by Claim.MD.
- All Support: Vendor can view all support tickets and any associated claim data.
- Full Access: Vendor has full access, can view all claim data, and has administrative access to the account.
- Click the button on the bottom of the page.
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