Claims Workbench


PracticeSuite Sales Training University

University

Practice Management Sales Training

Claims Workbench

View This Lesson on YouTube

In This Video You Will Learn
Batch and Submit claims. Print claims, review claim responses and work rejections

Go to charges>Submit claims
This area will demonstrate how to submit claims, check claim status, correct rejected claims and resubmit them

Pie Chart, it’s interactive click into any slice to show all claims on hold (for example)
Ready to submit bucket on the left
Claims can be filtered by provider, insurance company, DOS, etc., press generate batch
Clearinghouse will bring back the claim status within 24 hours
Show Electronic Claims bucket
Accepted are all claims accepted by the clearinghouse, accepted by the insurance
Rejected are all claims rejected by the clearinghouse, these need to be corrected and resubmitted
Click into this bucket
Press the plus button to show the rejection reason
Claims can be updated and resubmitted from this screen.
Click the patient’s name to show where demographics can be updated
Click the claim number to show where the claim information can be updated
Check off the claim or check the select all box, show where they can press rebill & generate claim to resubmit all rejected claims
Payer Rejected are claim rejected and not accepted by the payer, these are not denied claims, they just were not accepted into adjudication E19

Questions from above video

    1. Batching Workflow- claims for batching first show up in the Ready to Submit and then after batching in the Unsubmitted Batches/Error and once submitted, you can see them in either the Accepted or Rejected bucket.
    TrueFalse

    2. How does the system batch paper vs electronic?
    If the insurance has a valid payer id, it batches electronic else, it batches paper.When batching claims you can decide how they need to be batch – as paper or electronic.It is based on the Billing Method selected in the Insurance.All claims batch electronic by default and any electronic claims that need to be printed as paper can be done from the Print/Rebill screen.

    3. There is an autobatching feature available in the system. Claims will automatically batch at a preset time.
    TrueFalse

    4. Claims can be rebilled in bulk by the following these steps-
    Open Claims Workbench and Print/Rebill screen. Select/Enter the parameters to list the claims and then check the claims to rebill and hit Rebill.Open Claims Workbench and Claim History tab. Select/Enter the parameters to list the claims and then check the claims to rebill and hit Rebill.Open Edit Charges and then search the encounters. Once the encounters are listed, select all the encounters and use Rebill Line Status.No such option in the system. Claims have to be always individually rebilled.

    5. What claims show up in the Pending Response bucket?
    Claims that have been submitted and have no response from the Payer only.Claims that have been submitted and have no response from the Payer and/or Clearinghouse after 5 days.Claims that have not been either batched or submitted and waiting for submission and hence, awaiting further action.Claims that have been submitted and have no response from the Payer and/or Clearinghouse even after 30 days.

    6. From Claims Workbench, you can batch, print and submit claims but have to login using a separate browser to our partnered clearinghouse portal.
    TrueFalse