Producing an Electronic Claim

Electronic claims are produced in CILe by collecting all of the client's personal and insurance information and then producing a session note. The process of producing a session note causes CILe to collect all of the personal and insurance information previously entered and put that information into a format that the electronic claim clearinghouse can read. Once you have entered all of the personal and insurance information, all of this happens without any intervention by you. The details are as follows:

When the client makes contact:

1. Enter the client's personal and insurance information onto the Fiscal Face Sheet (via "Add New Client" off of the Administrative menu). If you have all of the information you need to submit your claims electronically, and you have the authorization from the client's insurance company to submit claims, then make sure you have checked the "Submit claims" as well as the "Submit electronically" checkboxes on the client's Fiscal Face sheet.
2. Get your client to sign a release allowing you to send their information to the clearinghouse.
3. Make sure your own personal information is accurate in the "Edit Employee Data" and "Edit Provider Insurance Info" screens off of the Administrative menu.

Then, for each session:

1. Put the client on the schedule (this is a required step).
2. Do their session note. CILe then collects information from the session note and the other information you have previously entered and automatically and seamlessly creates the electronic claim in the database with all of the required information.

Then, at the end of the week (or using whatever schedule you'd like):

1. Visually review the claims you've created on a screen provided by CILe (this is an optional step, but one that gives me an added layer of confidence in what I'm submitting).
2. Create the Microsoft Excel file (CILe does this for you with a mouse click) containing all of the claims you've created throughout the week.
3. Upload it to the clearinghouse via a quick and easy internet connection.

The menu selection screenshots are below:

To visually inspect the claims that are about to be transferred to the clearinghouse, click the "Verify / Delete Pending Eclaims" off of the Fiscal menu.

Then:

To create the Microsoft Excel file that contains the claims to be transmitted to the clearinghouse, click the "Transfer Pending EClaims to Excel" item off of the Fiscal Menu. You will get a chance to confirm that you are ready to do this. The creation process takes less than a second, and updates each of the session notes as having have claims submitted. Then, simply sign onto your clearinghouse's website and use their upload utility to upload the excel file to their site. The excel file will be in the "My Documents" folder in the "CILe EClaims" folder. It is named with your name plus today's date in YYYYMMDD format so you can keep track of when each file was created.