Insurance Processing Procedures:

• If any information is wrong in the Patient’s Insurance Record, it can be changed any time before billing is exported into the Export File.
• EX: If a patient is marked for Assignment but should not be, just make sure to change it in their Insurance Information before the File is transferred to Gateway EDI for Electronic Processing

Alert Fields to Check for On Each Billing Cycle:

• The following is the list of Alert Fields that need to be verified on all Insurance Claims being sent out, Paper and Electronic as described in the protocol above.
• For all Medicare and Major Med use the alert tab “Insurance Processing Export”
• Fr Medpay use the alert tab “Insurance Processing PI-Preinjury”

Printing Paper Claims (HCFA):

• Log into ChiroTouch Front Desk and Open Billing/Statements/Reports Screen
• Change Print Order to Ins Co Name for ease of sending them out so that claims will be printed out based on Insurance Co Order, not Patient alphabetical order
• Print Report
• See list above for Alerts Field.
• A report will generate if any fields need to be entered in Patient Insurance Info
• Print the report and enter the required information into the Patients INS info
• After entering info, repeat check for Alerts to ensure nothing was missed
• If all fields are correct and no info is missing, a screen saying All Data Verified will come up – click OK
• If you wish to print the claims right away, click Yes to the next prompt ‘Do you wish to print claim forms now?’ Make sure HCFAs are loaded into the printer
• Setup screen to print the HCFA forms will look like this
• Then, make sure all Alerts are cleared and choose Print
• HCFA (02-12)               Sample Text
• Left = 15 Courier New – Font
• Top = 29 Regular – Font style
• Bottom = (-2)               10 – Size

Processing Electronic Claims:

• Log into ChiroTouch Front Desk and Open Billing/Statements/Reports Screen
• Check the Billing Form is selected as CMS-1500 (02-12)
• Under the Case Types chose the Select All button then un-select the following:
• TO-Trade Out
• PI-Medpay
• NP-PIL
• F-Family
• CPIL-ClsdPI-L
• CPI-ClsdMEDPA
• CP4-PILpLiabili
• CP3-PIL-Liabili
• CP2-PIL-Liabili
• CP1-PIL-Liabili
• Ch-Charity
• Chose Select All under Providers.
• The print order should be selected as Ins Co Name
• See list below for Alerts to check for and check them off in the Alerts Box by single clicking over the top of them, then hit Export (this is for Electronic Claims)
• A report will generate if any fields need to be entered in Patient Insurance Info
• Print the report and enter the required information into the Patients ins Info
• After entering info, repeat check for Alerts to ensure nothing was missedIf all fields are correct and no info is missing, a screen saying All Data Verified will come up – click OK

• Cose ‘Yes’ to Export Claims Now at next prompt
• It will prompt you to save the Electronic Export File and do this by naming it with the Date you are exporting them: Ex: 2021-11-30 and it will save as a .txt file. Files should always be saved in the public drives>ChiroTouch>Gateway EDI Claims>Claim Submissions
• Each time this file is created, simply save according to the date you are building the file as described above.
• Now follow instructions for Transmitting Claims to Gateway EDI for Electronic Billing in the upcoming pages.