Claim Processing Automation

Close Batch After Posting 837

1. In the Automatically Close Batch After Posting 837 field, select Yes to close batches after an 837 file has been posted.
2. In the Provider Selection field, select All to apply this setting to all providers.
   • Select Individual to choose the providers (Provider/Classification field).
   • Select Classification to choose the classifications (Provider/Classification field).

Create Voucher After Closing Batch

1. In the Automatically Create Voucher After Closing Batch field, select Yes to create a voucher after a batch has been closed.
2. In the Segregate Vouchers To field, select whether vouchers containing Approved Services, Denied Services, or both should be created by import/export automatic file processing.
3. In the Provider Selection field, select All to apply this setting to all providers.
   • Select Individual to choose the providers (Provider/Classification field).
   • Select Classification to choose the classifications (Provider/Classification field).

Create EOB After Creating Voucher

1. In the Automatically Create EOB After Creating Voucher field, select Yes to create an EOB after a voucher has been created.
2. In the Segregate EOBs To field, select whether EOBs containing Approved Vouchers, Denied Vouchers, or both should be created by import/export automatic file processing.
3. In the Provider Selection field, select All to apply this setting to all providers.​
   • Select Individual to choose the providers (Provider/Classification field).
   • Select Classification to choose the classifications (Provider/Classification field).

Prevent Services From EOB Until Payment/Adjustment Posted

1. In the Prevent Services From Being Included on EOB Until Payment/Adjustment Posted in PM field, select Yes to prevent services from the selected providers or
   classifications of providers from being allowed on an EOB until a payment or adjustment has been posted for those services in PM.
2. In the Provider Selection field, select All to apply this setting to all providers.
   • Select Individual to choose the providers (Provider/Classification field).
   • Select Classification to choose the classifications (Provider/Classification field).

Generate 835 After EOB Creation

1. In the Automatically Generate 835 After EOB Creation field, select whether or not 835 generation should occur automatically after the EOB Creation form is filed.
2. In the Segregate 835s To field, select whether 835 files containing Approved EOBs, Denied EOBs, or both should be created by import/export automatic file processing.
3. In the Provider Selection field, select All to apply this setting to all providers.
   • Select Individual to choose the providers (Provider/Classification field).
   • Select Classification to choose the classifications (Provider/Classification field).

Generate 835 After Other EOB Information

1. In the Automatically Generate 835 After Other EOB Information field, select whether or not 835 generation should occur automatically after the Other EOB Information form is filed.
2. In the Provider Selection field, select All to apply this setting to all providers.
   • Select Individual to choose the providers (Provider/Classification field).
   • Select Classification to choose the classifications (Provider/Classification field).
3. In the 835 File Output Path field, enter the directory to store the 835 file.

Additional Sections

• Schedule EOB Creation
• Inhibit Retro Claim Adjudication