Overview

This Knowledgebase article will outline the process of submitting electronic claims in ICANotes+ by leveraging our integrated solution with a clearinghouse.

Subscribing to ICANotes+

In order to utilize clearinghouses for claim submission, it is necessary to have a subscription to ICANotes+. To subscribe to ICANotes+, please refer to the "Converting Your ICANotes+ Trial to a Paid Subscription" KB article.

Setting Up Clearinghouse

The software allows you to submit claims to ICANotes clearinghouse powered by Inovalon.

After your subscription is activated, you may reach out to our sales team to set up clearinghouse for your practice. Our sales team will assist you in setting up clearinghouse and provide training to submit the claims. Please be aware that claim submission won't be feasible until you've completed a training session with one of our trainers. They will assist you in sending your initial batch of claims.

Setting Up Your ICANotes+ Account for Billing 

To effectively submit claims to insurance payers via clearinghouse using ICANotes+, it's imperative to input the mandatory details. Make sure you've configured the essential settings in the following sections:

• Practice Settings
• Personal Preferences
• Settings in Chart Room

Practice Settings 

Navigate to Settings >  Practice Information >  General Information section and record the details that are depicted in the screenshot below:

• Place of Service Code (for example: 11 for office, 02 or 10 for telehealth)
• Practice Address
• Full 9-digit Zip Code
• NPI (typically the type-2 group NPI for the practice if available)
• Federal Tax ID and Type
• Billing Taxonomy Code (if needed by any of the insurance payers)

If you provide various service options, such as in-office and telehealth, navigate to Settings >  Practice Information >  Other Sites section and create an additional site to reflect the alternative Place of Service Code.

Navigate to Settings >  Practice Settings >  Service Codes Short List section to add service codes.

Once you add code and description, click the Add to list button as depicted in the screenshot below:

Navigate to Settings >  Practice Settings >  Modifier Short List section to add modifiers.

Once you add code and description, click the Create button as depicted in the screenshot below:

Navigate to Settings >  Practice Settings >  Payer Settings section to add insurance payers.

Once you enter Insurance Payer, Payer ID, and select the Insurance Type, click the Add Payer button as depicted in the screenshot below:

It is mandatory to record insurance payer address. After adding the insurance payer, it appears in the list as shown below. Click the Edit button and enter the insurance payer address. 

This field must be completed for successful claims submission. Failure to enter an address will lead to claim validation errors later on. Normally, you can find the address on the back of the client's insurance card or by searching for the mailing address of the insurance provider using your preferred search engine.

Personal Preferences 

Personal Preferences are specific to each user and any adjustments made will only impact their own account. For instance, if a user sets a billing rate to automatically appear for a particular service code within their individual preferences, this rate will solely populate in their account. Each user manages their own unique set of personal preferences.

To access personal preferences, click the dropdown arrow in the top right corner next to the logged in username and select the Personal Preferences option as shown below:

Navigate to Personal Preferences >  Personal Information >  Identifiers section to add identifier details.

Once you enter following details, click the Save button as depicted in the screenshot below:

• NPI (typically your type-1 individual NPI)
• Federal Tax ID and Type
• Rendering Taxonomy Code (if needed by any of the insurance payers)

Navigate to Personal Preferences >  Revenue Cycle Management >  Clinical Billing Rates section to set up billing rate for each service code. You only need to input the code and rate, excluding Insurance Payers or Modifiers. This will cause the billing rate to automatically appear when you choose the code in a note. Click Add to save your changes.

If you wish to modify existing Clinical Billing Rates, click the pencil icon located at the far right of each rate.

The Edit Billing Rate screen appears, enabling you to make any required adjustments. After making your changes, click on the Save button.

Navigate to Personal Preferences >  Revenue Cycle Management >  Claim Consents section and activate the consents by adjusting the slider as demonstrated in the screen below:

Settings in Chart Room 

Ensure that you have entered all the necessary details in the client's chart to be able to submit the claims successfully.

Following are the details you must record in the client's chart:

• Client Address
• Insured/Subscriber Address (if different than client)
• Insurance Information
• Consents

When you create a new chart from the Chart Room, you can enter client's address. Refer to the following screens:

If you forget to enter the address when creating a chart, you can still add it by editing the client's demographic information. Go to Chart Room > Demographics > Contact accordion and select the Edit button within the Addresses section, as shown in the screenshot below:

Clicking the Edit button will open the following screen, allowing you to enter the client's address and click on the Add button.

If the insured party differs from the client, such as a parent or spouse, it's important to include them as a contact and provide their address as well.

Navigate to Chart Room > Communications tab > Related Contacts accordion and click the Create New Contact button as shown below:

Enter the contact's First Name, Last Name, Type, Relationship, and click the Next button.

On clicking the Next button, the following screen appears to enter the Related Contact's address.

Navigate to Chart Room > Communications tab > Consents accordion and select the checkboxes for the following consents. See the screen below for reference:

• Consent on file authorizing release of information to process and/or adjudicate the claim
• Consent on file authorizing payment of medical benefits Save

Once you save the consents, it appears as shown below:

Navigate to client's chart and click the Account button from the top bar. Expand the Insurance accordion and click the Add Insurance link to add insurance details for the client. See the screen below for reference:

If you've included the insurance payer in the Settings, just type a portion of the insurance name and select it from the dropdown menu. This will ensure that the correct payer ID and address are automatically filled in. Then, input the Member ID/Policy Number, group number (if applicable), and any other necessary information. Finally, click on Next.

By default, the client will be designated as the primary insured, and their information will automatically appear. If the client is not the primary insured, utilize the dropdown menu to choose a Contact, or click on Create New Contact. When creating a new contact, provide the individual's First and Last Name, then click Save.

Submitting Claims from the Billing Worklist in ICANotes+ 

Client's encounter details appear within the Unbilled Encounters tab. You can review these details before submitting the claim. 

Navigate to Dashboard > Billing Worklist > Unbilled Encounters tab as shown below.

The Unbilled Encounters screen displays notes containing essential details about the encounter. 

Note: You can click on the blue text, such as "Client" and "Note Type," to promptly navigate to those sections and review or update client information or notes.

By scrolling to the right side, additional information becomes visible. Please refer to the screen below for reference:

Claim Date: Displays the date when the claim was submitted / rebilled.

Claim Frequency Code: Dispays the claim frequency code. The codes are: 01 - original claim, 07 - replacement of prior claim, or 08 - void/canel of prior claim.

Payer Claim#: Displays the payer claim number entered when submitting rebill.

Utilize the arrow next to the encounter date to expand and collapse the service code details for the encounter.

The Note Status will match the colors you see on the Dashboard: Signed notes are in blue, Finished notes are in green, and notes In Progress are shown in orange.

To ensure the accuracy and completeness of the information on the claim, you can verify whether any necessary modifiers, such as 95 or GT, need to be added to the codes, particularly for telehealth encounters. If modifications are necessary, click on "Note Type" to include them.

To confirm that the Diagnosis Code and Payer are included, scroll to the right to view them. If either is missing, you'll observe two dashes (--) in the corresponding column.

Once you've verified that all the information is accurate, you can proceed to submit claims. Select the check boxes on the left of each encounter. You have the option to select one or more encounters at a time. Once you select the desired encounters, click the Actions dropdown and select Submit Claims as shown below:

During the claim submission process, you may encounter the Loading notification depicted below:

After successfully submitting the claims, you'll find the toast message displayed as shown in the screen below. Subsequently, the claim is transferred to the Billed Encounters tab upon successful submission.

When you click the Submit Claims button, the system will verify the claims for any missing or incorrect information. If any issues are detected, the claim won't be submitted, and you'll encounter a notification. To rectify the errors, click the "Click to download .csv" button to receive a file listing all the error reasons. Then, address the errors accordingly and attempt to submit the claim again.

Include Secondary Payer when Submitting Claims to Primary 

By default, when submitting a claim to the primary payer, the system will also send the secondary payer details. However, if you prefer not to include secondary payer information, you can opt out. 

In the Unbilled Encounters tab, scroll to the right to find the Include P/S column. This allows you to uncheck the box for the secondary payer, as shown in the screenshot below. To include the secondary payer details when submitting to the primary payer, simply leave the checkbox selected. 

See Also 

You can access related Knowledge Base articles using the following links: 

Electronic Remittance Advice (ERA)

Add Payment or Adjustment from Account Ledger

FAQs 

You can find the Frequently Asked Questions (FAQs) on our Knowledge Base page.

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Need additional assistance?

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Text: 866-301-0085

Email: ticket@icanotes.com

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Proprietary Notice Information: This article is provided for informational purposes only, and the information herein is subject to change without notice. While every effort has been made to ensure that the information contained within this article is accurate, ICANotes cannot and does not accept any type of liability for errors in, or omissions arising from the use of this information.