1. Planned Systems International (PSI), Defense Health Services System (DHSS), Relay Health 2010 UBO/UBU Annual Educational Conference E-Billing for Beginners (Hands-On Training) 22-25 March 2010 Turning Knowledge Into Action

2. 1. Processing Claims Electronically Clearinghouse Payer Released ePremis Claims run thru Edit Masters TPOCS Claims Transmitted Submit 837 file Auto Agent Rejected Correct errors and validate claims Accepted Claim has no errors E-Billing for Beginners (Hands-On Training) Initial response is made by the payer if claim has been accepted or rejected. *Unreleased: Claims that are in ePremis and haven’t been sent to the Clearinghouse.

3. 2. Functionalities in ePremis  Log-On Page  Home Page  View/Modify Claims Page (Claim Filter)  Claim Display Page E-Billing for Beginners (Hands-On Training)

4. 2. Functionalities in ePremis  Values for Quick Claim Filter:,  “And” :  “Through” (Range) E-Billing for Beginners (Hands-On Training)

5. 2. Functionalities in ePremis  Billing Type: - Primary (A) - Secondary (B) - Tertiary (C) E-Billing for Beginners (Hands-On Training)  Claim Status: - Accepted - Rejected - Warning  Transmit Type: - Electronic - Paper - Locally Print

6. 2. Functionalities in ePremis  LOB (Line of Business) 1 – Medicaid 2 – Medicare 3 – BCBS 4 – CHAMPUS/CHAMPVA 5 – Commercial E-Billing for Beginners (Hands-On Training)