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Revenue Manager Send Secondary Claims

1. Starting from within Revenue Management, click the Select button and choose the 'Secondary' ->'Ready to Send ' claims.


2. Notice the indicator at the right of the claims windows has updated to 'SEC Ready'


3. Secondary claims that are actually 'Ready to Send' will be checked to send automatically.

If the claim is not checked automatically one of the following items must be addressed before sending the secondary claim out:

a. The primary claim status needs to be set to done, before the secondary can be sent through RM.

b. The primary payer must have a payment and under the payment "Apply" have the "Complete" box checked beside each transaction on the claim.  This includes when a zero dollar payment is made by the primary payer, it must still be entered into Medisoft showing the payment amount and indicating the primary payer is not longer responsible for the transaction line.


4. You will not have to use the 'Check Claims' button for secondary claims, because it assumes the primary has already been checked and corrected of any issues.


5. Select Send->Claims->Receiver Name

a. Errors will be red; print the failed error report (Print->FailedClaimEdits)

b. Remove all failed (failed claims status will change from ready->Alert)

6. Press Send Button


7. One of three things should happen at this point

a. Claims will process and send automatically to the clearinghouse (Relay Health, Capario, etc.)

b. Terminal window will open to connect to a dial up BBS to send claims

i. This process maybe automated with scripts (Medicare, Medicaid normally will)

ii. You may have to complete this process manually

1) Click Connect to connect, normally you will be presented with a user name and password prompt, these are provided by your clearinghouse

2) Check with your clearinghouse for specifics while inside the system, but when you reach a point to send the claims files, simply select the 'send file' button in the terminal at that time

c. A web site will launch and direct you to the clearing house web portal

i. Log into ClearingHouse

ii. File->Upload

1) Browse to Desktop->Shortcut to RMData->Practice Folder->Outbound (Find your RMData folder and then under the practice folder within the RMData folder, there will be an outbound folder, create a shortcut on your desktop to this location for easier access)  This location can be manually set in the receiver under transaction set.

2) Select the file you want to send (file name is defined in the receiver under transaction set)

iii. Close ClearingHouse site

iv. Click 'Yes' on "Claims were transmitted successfully

8. The RM Reports window opens automatically after sending claims, review any reports and then close the RM Reports window.

9.Close claim preview report

10. Close claim preview window

11. Close RM

12. Close Claim manager in Medisoft and reopen to refresh claim statuses