E-file a Claim in Tops Ortho
Here's how to send an eClaim in Tops Ortho!
STOP AND READ:
1.) To avoid submitting duplicate claims, we recommend you only e-file claims generated from this date forward.
2.) When you e-file custom claims (claims for which you have changed/overwritten any of the pre-set yellow placeholders in the claim template) the original template will override your changes and the claim will send in its original form.
- Go to Matrix > Claims.
- The default view of this report reflects Unsent Ready-to-File Claims, for All Offices, All Submission Values, and Open Claims Only; change the filters as desired.
- If a claim has no errors and is ready to be filed, it will be listed in Unsent Ready-to-File.
- Place a checkmark in the checkbox to the far left of each claim you wish to e-file. If you wish to check all the claims in the list, click the blue checkbox icon on the top left corner of the report.
- To uncheck all claims, click the blue checkbox icon with the red cross-out sign over it.
- When you have selected all the claims you wish to e-file, click e-File Checked Claims on the bottom right.
- After the claims are sent, they will be removed from the Unsent Ready-to-File Claims view.
- To view rejected claims, go to Matrix > Claims > Unpaid Claims. The default status filter will be Rejected by Clearing House. (One exception to this is when the character limit for the Remarks field (box 35) is exceeded. For more information on this, please see related article Character Limits for eClaims.)
- To view accepted claims, go to Matrix > Claims > Unpaid Claims and update the status filter to Clearinghouse Accepted.
- If the status of a claim is Clearinghouse Accepted, the claim was sent successfully to DentalXChange (the clearinghouse); you can track its progress with the payer in the DentalXChange portal: https://register.dentalxchange.com/reg/login?0.
- If the status of a claim is Clearinghouse Rejected see related article eClaims With Rejected by Clearing House Status, for further instructions. (One exception to this is when the character limit for the Remarks field (box 35) is exceeded. For more information on this, please see related article Character Limits for eClaims.)
In Tops v.9.11.0. - After resolving errors from claims that reflected a Clearinghouse Rejected status, the claims will be removed from the Rejected by Clearinghouse filter and reflect an Open status. You can locate the claim(s) either in the Unpaid Claims with Open Status Only, or you can locate these claims in Unsent Ready to File, updating the filters to All Submission Values, Open Claims Only. Once located, you can check the box and click the e-File Checked Claims button to submit again.
(NOTE: For Tops v.9.11.0, there is a current claim-flow issue that Tops developers are working to resolve. After submitting any eClaims that have been previously rejected and resolved, the claims do not disappear from your Unsent Ready-to-File count or the list of claims found in Unsent Ready-to-File, All Submission Values. The claims, however, will accurately reflect their status (i.e. Payer Accepted) and their submission dates. This has been corrected in Tops v.9.11.1.)