Generating Insurance Claims batch file and how to submit to Gateway EDI

Q: How do I generate an Insurance Claims batch file and submit it to Gateway?

A: First login to My Vision Express and follow these steps:

1.  Follow the menu item sequence … File | Reports | Insurance | HCFA/CMS1500.

(This will bring up the screen where you will generate the Insurance claims batch file)

 

2.  Search for the claims you would like to submit.  The search can be based on:

o  Claim Status

o  Insurance Type

o  Claim Created date

o  Claim Submitted date

o  Insurance Company

3.  By default the claim submitted date is left blank when a claim is created. This date is setup after creating the batch file.

4.  If you are re-submitting claims your best option will be the Claim Submitted Date. You can find the claims to resubmit based on their first submission date.

 

 

5.  Select your format settings.  On the bottom part of the screen you will find the format settings.  Make sure you select Electronic and Print Image or ANSI 837 which ever is appropriate. 

6.  Click on the Search Button.  After clicking the Search Button you will see the total number of claims found right below the Clear Button.  A processing window will appear.  Wait until the process is completed before doing anything else.

 

 

7.  When the process is completed you will get the following message: “Insurance Claim in CMS1500 Print Image Format/ANSI 837 Format has been created under C:\claims.txt”

 

 

 

8.  Click OK .

9.  A popup window will appear prompting you for a Submission Date. You can enter today’s date to update submission date for all the claims included in this batch file. This completes the batch file creation process. Now we’ll move on to the file submission process.

File Submission Process:

10. Access Gateway EDI website www.gatewayedi.com.

11. Log in to your account.

12. Select Send/Receive from the left hand side menu. You will get the following screen.

 

 

 

10. Select Claims and click the Submit Button.  The following screen will come up.

11. Click on the Send & Receive Button. Once the submission is completed you can click on the link below the Send & Receive Button to view the submission report and make sure the file was uploaded correctly.

 

 

12. If the file was uploaded correctly the status should be Received.