Manually Uploading Claims

Uploading Files Manually

"Manually Uploading Claims" refers to the process of generating a batch file containing all claims for a specific provider from the Practice Management System or other software system. This file is typically in ANSI X12 format, although it may be in other formats such as PDF, CSV, XML, or others. The batch file is then saved in a local drive and uploaded into Claim.MD.

To upload a claim:

1. Click Upload Files on the left-hand navigation menu.
2. It is recommended to leave Select Format dropdown as Automatic Format Identification first.
   If the document is not being automatically read, try selecting the specific format (CSV, XLS, XML etc.) in the dropdown.
   More Information

   Clicking on the button located next to the Select Format dropdown will result in the appearance of a window named Select Format Help. This window will contain links to assist in understanding the rules and formats required to set up a document accurately for uploading to Claim.MD. For example, if a CSV file is being used, a template will be provided indicating how to arrange the column headers.

   
3. Click the   Select File... button
4. Browse the local drive and locate the claim file to upload. Double click on the file or click the Open button. 
5. Click Upload Selected Files button. A loading circle will display while it uploads.
6.  An Imported Data Results window will display with the number of claims transmitted, held (to be approved before transmission), and rejected. 
   1. To stay on the screen, click OK . 
   2. To approve claims that are held or review rejected claims, click   Manage Claims .
7. The Recent Uploads section of the page is where you can quickly view information about your batch file such as quantity of claims in the file, total amount for the claims, etc.
8. Click the View Claims button to see the individual claims in the file.
9.  The next step will be addressing claims that need attention (such as claims needing approval, and rejected claims), which is handled in the Manage Claims page. 

Attachments

To search for payers that allow attachments, first click on this link to access the payer's list. Once you're on the list page:

1. Type in "Attachments": In the search box at the top of the page, type "Attachments".
2. View Updated Results: After entering "Attachments," the list will automatically update, showing only those payers that accept attachments.

After creating or uploading a claim to a payer that accepts attachments, you’ll see an "Attach Documents" link at the top of the claim form in Claim.MD.

1. Click on the Attach Documents link. 
2. Click on Select A File.
3. Select the file from your local drive.
4. Close the Attach Document Window.
5. The link will now display the number of documents attached.
6. Be sure to select the appropriate Attachment Type.

Once a claim is created or uploaded to one of the payers in the list above, there will be an Attach Documents link at the top of the claim's form in Claim.MD.

1.  Select   View Claims  on the Upload Files or Manage Claims page. Select an individual claim from the list to View / Edit the claim. 
2. Click on the Attach Documents link. 
3. Click on Select A File.
4. Select the file from your local drive. 
5. Close the Attach Document Window.
6. The link will now display the number of documents attached.
7. Be sure to select the appropriate Attachment Type.

Uploading a 270 File for Processing

To upload a 270 file, follow the same process as uploading a claim file. Go to the "Upload Files" page and select "ANSI X12" as the file type. Once the 270 file is uploaded, it will be processed, and a corresponding 271 file will become available for import.