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Benefit Enrollment and Maintenance (834) Submission - PM

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Create a benefit enrollment and maintenance (834) submission file for a guarantor or payor. The 834 file includes all clients for qualified guarantors. The file lists the start and end dates of payor enrollment. Each 834 file can contain multiple client information, multiple guarantors information, and coverage for multiple dates of service.

Prerequisites:

  • The Enable 834 Submissions registry setting must be enabled.

  • Guarantors must be associated with 834 information in the Guarantors/Payors form (Benefit Enrollment and Maintenance (834) section).

  1. Go to: Avatar PM > Billing > Electronic Submission > Benefit Enrollment and Maintenance (834) Submission
  2. In the Options field:
    • Select Compile File to assemble 834 information into a file. Errors can be reviewed by generating the Benefit Enrollment and Maintenance (834) Submission report (select Run Report in this field).
    • Select Dump File to generate a report of the compiled 834 file. The report displays the contents of the 834 text file.
    • Select Create File On Server For Submission to the 834 file on the server.
    • Select Run Report to generate a Benefit Enrollment and Maintenance (834) report for an 834 file. The report details the data submitted in the benefit enrollment and maintenance file, and any errors processing the 834 file.
    • Select Delete File to remove an 834 file. Information in the file can be compiled again into another file.
  3. In the Individual Or All Guarantors field: 
    • Select All to compile the 834 inquiry file for all guarantors.
    • Select Individual to choose a guarantor (Guarantor field).
  4. In the Guarantor field, select the guarantor.
  5. In the Through Date field, enter the last service date for the 834 file. 
    Note: This date is based on the Data Entry Date field, in the client's Financial Eligibility form.
  6. In the File Description field, enter the 834 file name.
  7. In the Select File field, select the 834 file. 
    Result: This field displays the compiled file status, date and time compiled.
  8. Select Process File to process the action selected in the Options field. 
    Note: If the compiled file is missing information, the benefit enrollment and maintenance file cannot be submitted.
  9. Use the Benefit Enrollment and Maintenance (834) Submission report (select Run Report in the Options field), to review the missing information.

The Benefit Enrollment and Maintenance (834) Submission report contains the following sub-reports:

  • Compiled Data: Sorted by client and displays benefit enrollment information for the client, including the period of enrollment coverage.
  • Errors Associated With Compilation sub-report: Sorted by client, and details errors encountered when the file was compiled.
► Registry Settings