Artificial Intelligent (AI) Insurance Claim Connectors
The AI Insurance Claim Connectors facilitate the creation and sending of claims.
Insurance Claim connectors are plug-ins associated with the various Claim payers Filopto supports. Depending on your Filopto version (USA or Canadian) different claim connectors will be used to process Insurance Claims. Custom Claim connectors can be programmed for specific situations (contact your sales person for more information).
The Claim Connector we currently support are:
▪USA - CMS-1500 (covers over 3,400 payer organizations - paper format)
▪USA - CMS-1500 ( Custom ANSI X12 format - extra cost - see ANSI X12 835-837 Claim Connector)
▪Canada - BC-MSP
▪Canada - Alberta Health
▪Canada - Manitoba Health
▪Canada - Manitoba Blue Cross
▪Canada - OHIP
▪Canada - NS-MSI
▪Canada - Generic
To activate a Claim Connector you must create an Insurance Profile in the Insurance Manager for the Insurance company you wish Filopto to create a claim. in all situations the basic information needed is similar with various connectors having fewer or additional information or features available.
IMPORTANT:
Each claim jurisdiction has specific requirements on how to successfully submit claims. YOU MUST REVIEW AND FOLLOW YOUR SPECIFIC JURISDICTION CLAIM REQUIREMENTS BEFORE USING THE CLAIM CONNECTOR.
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To create an Insurance Company profile see Create New Insurance Company Profile in this help file.
In the Filopto Canadian version an additional tab is available per insurance company to record the Claim Submission Information for completing the Canadian claim.
This tab contains the information required by the insurance provider to submit a claim. The user must complete the required information for the Canadian claim to be accepted and processed. Each connector contain sub tabs specific to the insurance provider requirements.
The Provider Information is the information used for billing purposes, it maybe the provider or practice information depending on the insurance carrier.
The Office Information tab is required for some carriers which require you to send claims on a per office basis which means an entry in the grid below must be made for each office identifying the office and other related information. If claims are submitted on a Corporate basis (not by the offices individually) then only one entry identifying the practice information needs to be entered. (see each connector help section for additional settings)
