Electronic Insurance Billing

  1. In the Accounting app, click on EDI Claim Batches.
  2. Set Thru Date as one day prior to today. Select case types one at a time and click Review.
  3. Check each case type for billing accuracy (make sure charges are at current billed amounts, extremity x-rays need modifiers, Medicare non-covered services need modifiers, Optum 97014 needs to be changed to G083). For Medicare, you will need to set the onset date for each patient. In the Front Desk app, go to Patient Management; search by last name; DX tab; click on yellow box to change date of current illness to the date of service you are billing. You can select yes to use the date for future appointments (you will need to change it when you actually bill).
  4. After you have reviewed a case type, click Create. If there are errors, correct them, otherwise go on to the next case type until there are no more claims to process.
  5. Once all the claims are prepared, log in to Availity. Click on the Claims & Payments tab; under EDI Clearinghouse, click on Send and Receive EDI Files; in the drop down menu select Kyle; click submit; again, in the drop down menu select Kyle; click submit; Send Files. Click Choose Files > Network > CTServer > CTData > EDI > Availity > OUT. Select all files then click Upload File. You each file will say success at the end after it has sent (may need to refresh this screen by clicking on Home then Send Files).

Updated 7-31-2024

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