Electronic Direct Connect Claims Integration


With the Electronic Direct Connect Claims Integration function, you can enter the information required to set up each type of electronic claim your practice will be sending.

Note: You must contact your Account Representative to initiate the registration process prior to sending claims. When registration is complete, you will be provided detailed information on completing the Electronic Claims Integration screen.

Upon accessing this function, you need to select the Insurance Form Number you want to set up.



Sample for Form Type 40



Data Field Information
Prompt Response Req Len
Direct Submission If you are sending these claims directly to the payer rather than via the eMEDIX, select this check box.   1
File Extension Type the File Extension, which is generally a letter followed by the database number.   3
ECS Location Select the location code that this type of claim is sent to from the Location Code list. 4
Interchange Sender ID (ISA06) Type the Interchange Sender ID number. 15
Interchange Receiver ID (ISA08) Type the Interchange Receiver ID Number. 15
Application Sender's Code (GS02 or Loop 1000A NM109) Type the Application Sender's code. 15
Application Receiver's Code (GS03 or Loop 1000B NM109) Type the Application Receiver's code.   15
EMC Provider ID/TAX ID Number Type the unique number assigned to the provider for Electronic Medical Claims (EMC) identification purposes. 15
Receiver Name (Loop 1000B NM103) Type the name of the entity (insurance carrier/administrator) who will receive these claims files. 60
Site ID Type the Site ID.   10
Primary Identifier If filled in, this will be sent in Loop 1000B, Segment NM109 of the 5010 electronic claim file which is populated by the Receiver Code.   80
Include NPI Numbers in Claims If you want the NPI numbers from your tables to be included in the electronic claims, select this check box.   1
Suppress Legacy Numbers If you want to suppress all legacy numbers from being included in the electronic claims, select this check box.   1
Split by GS Enter 'Y' to generate separate file per submitter (for direct sends only).   1
4010 Test/Prod Indicator Select the appropriate option to indicate whether the submission of claims is in the Test phase or is in Production. 4
4010 DOS Download Path Type the DOS path that the claims files will be downloaded to. 50
End of Line Terminator Select the end-of-line terminator to be used in the generated claim file (for example, Carriage Return & Line Feed).   1
5010 Format If claims are to be sent in 5010 format, select this check box.   1
5010 Test/Prod Indicator Select the appropriate option to indicate whether the submission of claims is in the Test phase or is in Production.   1
5010 DOS Download Path

Self-Hosted Clients Only - To download your 5010 claims to a folder on your server, type the full path to the server location to output your claims to—for example, C:\FolderName.

  50
5010 MyReports If you want the 5010 claims report sent to MyReports, select this check box.
 
Hosted Clients - This is the required method to use.		   1