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Kareo Help Center

Insurance Company Electronic Claims Settings

Updated: 07/08/2020
Views: 4618

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. 

Navigate to Electronic Claims Settings

  1. Click Settings > Insurance > Insurance Companies. The Insurance Companies window opens.
    Note: The Insurance Companies window is also known as the Enrollments Dashboard.
  2. Find the insurance company then click the insurance company name. The General tab of the Edit Insurance Company window opens by default.
  3. Click the Electronic Claims tab.
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Electronic Claims Settings

  1. Select the appropriate settings for the insurance company when applicable. 
    1. Click to select or clear the selection for "This payer accepts electronic claims". 
      Note: When enabled, this option allows the submission of electronic claims for this payer. 
    2. Select the Clearinghouse with which you are enrolled in the drop-down menu.
    3. Electronic Payer Connection: Click Electronic Payer Connection to search and select the payer connection. 
      Note: This is also known as the Payer ID and is used by the clearinghouse to route the electronic claims to the appropriate payer for processing. 
    4. Once the payer connection is selected, review the shaded checkboxes on the right.
      • "Requires authorization or enrollment" indicates enrollment agreements are required for electronic transactions with this payer. If not already completed, submit an enrollment request for this insurance company.
      • "Supports patient eligibility requests" indicates this payer supports electronic patient eligibility requests (also known as real-time eligibility checks).
    5. When there are multiple practices within the Kareo account, the Enrollment Status by Practice section displays each practice and its enrollment status with this payer.
  2. Click Save.
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