Viewing and Correcting Claim Errors and Printing HCFA
This section is an overview of how to view and make corrections to rejected claims. Once corrections have been made to a claim, you will have the option to resubmit the claims to the clearinghouse before it is forwarded to the payor.
Claim error reports are generated and shown on the small red circle at the top of the navigation bar of your appointment dashboard.
A. Viewing Claim Errors
1. Click Red Circle at the top left side of the navigation bar. The page refreshes and shows all claims that have errors or rejected by payer(s).
2. Click on "Show Error" to view the error message.
B. Correcting Claim Errors
1. Click on "Show Error" to view the error message.
Based on the error message from the payer, now you have to make changes to the invoice or make corrections to the patient's contact or insurance details.
2. Once you have made corrections to the patient's contact details or invoice, you need to edit the primary claim and submit it again.
Click on the small red circle at the top again and search for the claim that you want to resubmit again after making the necessary corrections.
Click 'Edit Primary Claim' at the right end of the claim that you want to resubmit.
3. The HCFA form will open. Scroll down to Box 22 - Resubmission Code. Depending on the insurance company, select the resubmission code from the dropdown list.
Click 'Submit Claim' at the bottom of the HCFA form. The new corrected claim will be submitted again to the clearinghouse.
Note: Box 22 (Resubmission Code) on the HCFA form for Medicare should ALWAYS be 1 regardless if it is the initial submission or rebill.
C. Printing HCFA
1. To print the HCFA form, you can either click "Print" or "Print HCFA*" at the bottom of the HCFA form.
*Note: When submitting paper claims, it is possible to include more than six procedure/CPT codes. An example of this occurs in personal injury cases (PI). In such scenarios, it may be necessary to bill more than the standard six CPT codes, sometimes requiring up to ten codes. To accommodate this requirement seamlessly, our zHealth system has been designed to generate two HCFA forms for the same Date of Service (DOS). The initial HCFA form includes the first six CPT codes, while the subsequent HCFA form incorporates the remaining four CPT codes.
When submitting electronic claims, your clinic can submit more than six procedure/CPT codes. For instance, if you have the need to electronically bill ten procedures/CPT codes, our zHealth software allows for this capability. However, it is important to note that only the first six codes will be displayed when utilizing the HCFA printout function within the zHealth software. Rest assured that all ten procedure/CPT codes will be transmitted seamlessly to the clearinghouse via the Electronic Data Interchange (EDI-837) protocol on the backend.
Posting Payment When an EOB/ERA is Split (not all CPTs on one claim)
zHealth has been designed to post payments for a full ERA (not some CPTs on one ERA and others on another). zHealth is looking to accommodate for this workflow in the future. Sometimes, insurance companies split the claim into 2, 3, or more ERAs ...
Printing or Emailing Invoice to the Patient
You can print or email an invoice any time after a patient has been billed. Here is how to print or email an invoice to the patient. 1. Navigate to the Patient Chart. You will be at the Summary section of the patient profile. Click on the 'Patient ...
How to Remove or Change an ERA Payment
Payments received electronically and reported in an Electronic Remittance Advice (ERA) can be posted manually in zHealth Billing Center. You can manually apply payments after checking ERA received date, ERA posted date, denials by the insurance ...
How to Batch Print Claims
You can use zHealth's 'Print Claims' feature if your payer requires you to print and send claims directly, instead of electronically. This help article covers how to batch print a group of claims that you are mailing directly to the payer. 1. From ...
Posting an ERA
Improve productivity by automatically posting insurance payments and streamlining the payment posting process. Billers or providers, depending on who is managing the billing process, can automatically post insurance payments by posting ERAs. An ...