Permissions: You must have Billing Permissions with the ability to "Submit Claims to Clearinghouse" enabled.
In order to use WebABA to process Claims, you manage your subscriptions to add Claims and then enroll your Payers. If you have not done that, you will not be able to see all the tabs described below.
There are 5 steps in the Claims Process:
The first few steps in the Claim Lifecycle
Create an Invoice, do a basic Claim Scrub, and Submit the Claim to Insurance.
- Create the Invoice.
Add the Invoice to Awaiting Submission - The Invoice becomes a Claim and sits in the Awaiting Submission queue. All Claims in Awaiting Submission are sent each business day.
- While you Claims are Awaiting Submission, you can perform a general Claim scrub. Claims can be checked for common errors such as Date of Birth, Gender, Address, Diagnostic Code, etc. If a Claim has no errors can be submitted to Apex.
- Claim is submitted to Apex. Here it is checked again for errors.
The last few steps in the Claim Lifecycle
Process Accepted or Rejected Claims, and Process ERA payments.
Claim is Accepted or Rejected.
- If the Claim is Accepted, it will move to the Accepted tab.
- If the Claim is Rejected, it will move to the Rejected/Denied tab where you can view the rejection codes/reasons and resubmit.
- ERA Received.
- Claim is Accepted or Rejected.