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Kareo Help Center

Electronic Claim Settings

In order to submit claims electronically, you must first be enrolled in Electronic Claims Services. Once enrolled, you can configure electronic claim settings for an insurance company. This is a permission-based task; if you do not have access to configure settings, please contact your Kareo PM application administrator.

To configure electronic claim settings

  1. Click Settings > Insurance > Find Insurance Company.
  2. Once you find the insurance company, double-click to open the record.
  3. Click the Electronic Claims tab. Select your settings. See below.
  4. Click Save or the Practice Settings tab to complete practice settings information.

Electronic Claims Tab

Insurance Company - Electronic Claim Settings.jpg

  1. This payer accepts electronic claims: Check this box if this insurance company accepts electronic claims.
  2. Clearinghouse: Select the clearinghouse with which you are enrolled.
  3. Electronic Payer Connection: This is also  known as the Payer ID. The Payer ID is used by the clearinghouse to route your electronic claims to the appropriate payer for further processing. Click the Electronic Payer Connection button to search, locate and select the payer connection (you can search by Payer name or ID); once you find the payer, double-click the line item to add it.
  4. Once the payer is selected, review the checkboxes on the right:
  • Requires authorization or enrollment: If checked, enrollment agreements are required for electronic transactions with the payer. Submit an enrollment request for this payer through Kareo (if not already completed). 
  • Supports patient eligibility requests:  If checked, the payer supports electronic patient eligibility requests. 
  1. Enrollment Status by Practice: Accounts with multiple practices can see which practices are enrolled with the selected clearinghouse.
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