Eclaims

We are a re-seller for Relay Health (a division of McKesson). The electronic claims module of all Temple Systems software is designed to send claims via this company. Below is a description of the working and billing of Eclaims.

The way it works

Sending: Anytime claims are processed (nighttime processing or manually), an ANSI837 file is created and automatically sent via secure FTP to Relay Health. You get an email within 15 minutes letting you know that the file was received properly. Relay Health then processes the file and creates reports. Reports are also generated on data that Relay Health receives from payors which you have sent claims to previously. These reports are made available to be downloaded every 4 hours.

Receiving Reports: Once reports are available for download, you can download and print them by clicking on the Print_ReportsFTP icon on your desktop. This process is done automatically by the task scheduler each morning.

Reading Reports: The reports exist for a reason. They need to be reviewed daily. They will tell you which claims went, which claims had errors at Relay Health, which claims had errors at the payor, and several other things. A detail of what you may see can be viewed here.

The Billing

Minimum Billing: There is a minimum billing fee of $35 per month. This is a $12 admin fee and $13 in minimum claim charges. The per claim fee is 25 cents for commercial claims and 30 cents for all Blues and governmental (Medicare, etc.) The minimum claim fee only covers commercial claims. The fee for paper claims is 55 cents. The fee for ERAs is 15 cents. A typical 50 visit per day clinic has a bill in the neighborhood of $60. You don't have to have them do paper claims. You can do those in your office if you wish.

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