Filopto supports several Claim Connectors allowing users to submit claims to various claim payer organizations. Depending on the configuration of your system you may have access to more than one claim connector.
The Claim Connector we currently support are:
▪USA - CMS-1500 (covers over 3,400 payer organizations, for a complete list see http://www.trizettoprovider.com/resources/payer-list)
▪Canada - BC-MSP
▪Canada - Alberta Health
▪Canada - Manitoba Health
▪Canada - Manitoba Blue Cross
▪Canada - OHIP
▪Canada - NS-MSI
(For more information on each connector see below and also the Insurance Help section Claims Connector Information )
Once you have created an Invoice and assigned the amount to be paid by an Insurance Payor in the various Invoice Item detail screen you can select the appropriate Claim Payor from the insurance policies assigned to the Patient from the Insurance Information section Primary drop down field (1) located at the lower left section of the Invoice. Once a Claim Payor is selected press the Primary Claim button (2) to open the claim Processing screen.
To Create a claim select the Prepare/ Update button in the Insurance screen (item #1). This will create a claim based on the insurance rules for the selected insurance carrier. Once the claim is created the Primary Claim button will show a number beside it indicating how many claims have been generated (item #2). More than one claim can be generated based on the rules of the insurance carrier.
To EDIT or view a claim double-click on the claim listed in the grid (item # 3) and it will open the insurance form for the selected insurance carrier. Filopto supports several different claim form connectors. The following sections explains the various claim screens which can be displayed based on the type of claim form being used.
Remove Insurance Policy from Claim record
Users can remove an Insurance company from a Claim record by using the Remove Insurance Policy button (1). The button (1) is available if no claim has been created or a created claim has been voided leaving no active/payable claim.
