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🇺🇸 Integrated Claims with Claim.MD - FAQs

  1. US Insurance Billing Additional Resources
  2. 🇺🇸 Integrated Claims with Claim.MD - FAQs

    3. 14 min read
    Practice Plan Thrive Plan

If you have questions about working with Claim.MD in Jane, you’ve come to the right place. Here, you’ll find answers to some of the most commonly asked questions about Integrated Claims with Claim.MD, along with some helpful troubleshooting tips.

If you’re brand new to working with Claim.MD, we suggest getting started by visiting our 🇺🇸 Integrated Claims with Claim.MD guide. This goes over how to connect your Claim.MD and Jane accounts and get started with Integrated Claims.

Scroll through all of our frequently asked questions or jump to a specific topic below: 👇

Getting Started

Eligibility & Enrollment

Submitting Claims

Getting Started

⭐️How can I receive a 10% discount on myClaim.MD subscription?

Whether you’re already using Claim.MD or have recently signed up, you can reach out to them and let them know you use Jane. They’ll take it from there!

⭐️Which vendor access should I select?

With your permission, the Jane support team may take a look at your Claim.MD account for troubleshooting purposes. Claim MD’s vendor access settings control how much we can view in your account.

  • Full Access would allow our team to see your integration settings, your claims, and any support tickets that you’ve opened with Claim MD.
  • All Support provides our team with access to your support tickets with Claim.MD and gives us limited visibility into your claim information.
  • Limited Access provides us with a limited view of both your support tickets with Claim.MD and your claim information.

We’re able to be the most helpful when we have Full Access but we’re happy to work with whichever access level feels best for you.

You can adjust this setting by logging into your Claim.MD account and heading to Settings > Account Settings > Vendor Access.

⭐️Does claim MD use my bank account information to directly deposit payments?

Your EFT (Electronic Funds Transfer) and direct deposit setup is managed directly between you and your insurance company. Think of ClaimMD as a helpful messenger that passes along important information, but doesn’t handle the actual banking details.

If you ever need to update your banking information for EFT payments, you’ll want to reach out to the insurer directly. They’re the ones who manage these financial arrangements, so they’ll be able to help you make any changes smoothly and quickly.

⭐️Can I start submitting electronic claims right away?

With most insurers, you can submit claims right away since they will have automatically enrolled you for electronic (also known as EDI) submissions. That said, it is worth double-checking as this may not be the case for all insurers.

While you can start submitting claims right away, it can take between 5 and 30 days to be approved to receive responses electronically (also known as ERAs). This means that even if you submit claim through Claim.MD, you’ll still receive the responses in your previous clearinghouse until your ERA enrollment is approved.

For that reason, we recommend that you continue submitting your claims in your previous clearinghouse until all your ERA enrollments are approved.

⭐️Can I still record payments from my previous clearinghouse?

You can still record responses from any claims that were submitted before switching to Claim.MD. You can do this by uploading your ERAs into the Remittances folder under the Billing tab.

Here’s a step-by-step guide on Posting Insurer Payments With Electronic Remittances (ERA).

⭐️Where should I reconcile outstanding claims that were submitted through my previous clearinghouse?

If you have any outstanding claims that were submitted in your previous clearinghouse, we recommend that you reconcile them there to prevent any confusion. This would include posting payments for visits that were submitted from a past EHR, or if the patients’ visits don’t populate in your Jane account.

💡 For more tips on how to ease the transition to from your current clearinghouse, check out our guide on Switching clearinghouses to Claim.MD.

⭐️What are the different access levels in Claim MD?

Deciding which access level to grant a staff member in Claim.MD depends on the areas they need to access in order to complete their daily tasks. There are four different user types in Claim.MD:

  • Administrator: Users can manage other users and can access all the settings and features. SFTP/API setup can only be performed by this access level.

  • Standard: Users can be restricted to specific features, but will have access to all provider’s data within those features.

  • Eligibility Only: Users can only access Eligibility and are locked to one specific provider. They are unable to see any eligibility history except their own.

  • Accounting/Invoices: Users have access to the View/Pay Invoices page only.

⭐️What do I do if the account number is not recognized by Claim MD or Jane?

You’ll need to complete a quick account verification process when you’re setting up your Claim MD account. Don’t worry - Claim MD provides the verification account number you’ll need, and you can easily find it in Box 26 of the CMS 1500 form in Claim MD.

Just a heads-up💡: Claim MD’s support team typically doesn’t handle the validation process directly. No problem though! If you’re stuck, ask a colleague who has access to your clinic’s Claim MD account to help you verify the patient name associated with that account number.

Eligibility & Enrollment

⭐️Should I enroll in both EDI and ERA submissions in Claim.MD?

Most (but not all) insurers will automatically enroll you for EDI submissions to submit your claims. For all insurers, you will need to enroll for ERAs in order to receive claim responses.

You’re able to see which of your insurers require your enrollment in your Claim.MD account. Select Prov.Enrollment on the left-hand side of the screen and review the 1500 Claims column. This will let you know whether any action is needed on your end.

Claim.MD does a great job of outlining these steps in their Quick Start: Enrollment guide.

⭐️I can’t find my payer in Claim.MD’s payer list — what should I do?

Claim.MD has an extensive list of payers, but if yours isn’t on that list, they can help! You’ll first want to verify the payer name and Payer ID to confirm it is not listed differently in ClaimMD with a different name or alternate Payer ID. An example of this would be BCBS Florida but the name Claim MD has is FL BCBS.

Once you’ve confirmed this information, you can reach out to their support team by clicking Support Ticket in your Claim.MD account to request that a payer be added.

⭐️Can my Claim MD ERA Enrollment expire?

Your Claim MD ERA Enrollment will expire if you do not submit to each insurer/payer within 30 days of enrollment.

If your enrollment times out, you will need to re-enroll with the payer. Alternatively, if you used Quick Enroll you will need to contact Claim.MD support to reset the Quick Enroll feature.

Submitting Claims

⭐️Why do either Box 32 or my service location appear blank in Claim MD when it’s filled out in Jane?

Due to US submission requirements, Jane will leave Box 32 blank if your billing provider address and service provider address are the same.

While this generally satisfies the requirements of most insurance companies, some may request Box 32 to be filled in for the claim to be processed. In that case, just let Claim.MD know and they can make this adjustment before submitting the claim to the insurer.

And of course, if you run into any hiccups or have any questions about this process, just send our team the details at [email protected] and we’ll be happy to lend a hand.

⭐️Can Integrated Claims automatically attach charts to my claims?

Not at this time. If chart notes are required for a submission, you can export your charts from Jane and attach them to a claim in Claim.MD.

To do so, you’ll want to enable Transit Approval Required in your Claim.MD account, which you can find by clicking on Settings > Account Settings.

This will disable automatic submissions to your insurers to make sure that you have time to attach any required files before they’re submitted.

Then, just click on Attach Documents within a claim.

If attaching chart notes to your Integrated Claims would be helpful for your clinic, we want to hear about it! Let us know by adding your vote to this feature request.

⭐️What is a Claim.MD Trading Partner/Submitter ID?

This is a unique identifier, like a digital address, that ensures electronic healthcare transactions are sent and processed by the correct organization securely.

⭐️Where can I find my Trading Partner ID in Claim.MD?

Once you’ve logged into your Claim.MD account, click on Provider Enrollment within the left sidebar menu and select one of the listed providers.

Next, click on the Payer Link under the 1500 Claim column. This link varies depending on your clinic’s specific set up.

An image of where to fin this information within Claim.MDs platform

⭐️Do I need to use Jane’s integration with Claim MD to bill personal injury claims?

No, you don’t need Claim MD to bill personal injury claims. However, integrating your Jane account with ClaimMD comes with some pretty nice perks! You’ll get streamlined billing and ERA management, save time and money, and even enjoy a 10% discount on your monthly Jane subscription.

The best part? Getting set up is super simple. Our supportive onboarding makes the process smooth and straightforward. These features are designed to boost your clinic’s efficiency, improve billing accuracy, and help you manage your cash flow more effectively. For clinics looking to level up their billing operations, ClaimMD can be a game-changing tool.

⭐️Why does my “Accept Assignment” keep switching from no to yes for my Claim MD submissions?

The CMS 1500 claim form shows “Accept Assignment” and “Signature on File” as two separate fields, but when it comes to electronic claim submissions, things get a bit tricky.

If you’re seeing the Accept Assignment field set to Yes in Claim MD, even though you set it to No in Jane, it could be related to your Signature on File setting. To ensure the insurer pays the patient directly, you’ll want to set both Accept Assignment and Signature on File to No in the patient’s insurance policy in Jane.

Note📝: The CMS 1500 claim form has separate fields for Accept Assignment and Signature on File, but these are combined on the EDI file for electronic claims.

To start, you’ll want to head over to the patient’s profile and click on the Billing tab > Insurance Policies > View > Edit . Next, scroll down and select No for both Signature on File and Accept Assignment.

If you’re still having issues, you may want to contact the insurer directly to confirm their specific requirements and why payments are not going to the patient as expected.

Want to dive deeper into Integrated Claims with Claim.MD? Check out some other resources here:
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