Creating Claim Files 101-AFC

Creating Claim Files 101-AFC

CREATING CLAIM FILES 101

1.  Once you have logged into PA, go to the Admin tab, you will be on the option for 837s.

2.  Under "Create 837 Files" look for the EDI Services dropdown menu and choose the EDI Service you want to create a file for.  The “Awaiting EDI” radio button will already be chosen.

3.  If you want to include claims saved on the same day, check the "Include Claims Released today".

The available claim count for any available claims that fit these categories will display.  If 0 appears, then there are no claims.

You may click on each EDI Service with the "Include Claims Released today" checked or unchecked and see if there are any claims to create a file for.  If no claims, no claim file to be created.

4.  Once you have the above parameters chosen and there are claims to create a claim file with, click on "Make 837 Files".  This will gather the claims into a file and "ANSI file created successfully will appear when the file is complete.

5.  To view, open or send the file somewhere, go to "Search 837 Files" and choose the Status "All" and click on "Show 837 Files".  Locate the file(s) you created by the date and time you created them.) 

6.  Then you can right click over the "File Name" to open the file into another window or tab or to save it to your computer.  Once it is saved to your computer you can send it via email (password protected per HIPAA) or put it on an FTP or SFTP site.

 You can run through this process and "Make Test 837 Files" instead if you want to make a practice run of this.  So, in place of Clicking on "Make 837 Files" you will click on "Make Test 837 Files".  Test files cannot be submitted as real live production files for payers to process, because the files are labeled inside as TEST FILES.  But you can create these just to see how the process works and it won't interfere with the current status of the claims, Awaiting EDI Submission. 

Once live production files have been sent to your clearinghouse you may want to come back to this screen and change the status of the File Name to "EDI File Confirmed" since you are aware the files were submitted successfully.  

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