Other Clearinghouse Claims Process Overview

Permissions: You must have Billing Permissions with the ability to "Submit Claims to Clearinghouse" enabled.

When you are connected to a non-partnered Clearinghouse, the information available within TheraNest after you've submitted the Claim will be limited.

Submit Claim with an Other Clearinghouse

1. Create the Invoice.
2. Add the Invoice to Awaiting Submission - The Invoice becomes a Claim and sits in the Awaiting Submission queue. 
3. Perform a Claim Scrub - While your claims are in 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 it can be submitted to the Clearinghouse.

   NOTE: TheraNest does not check if this information is correct/accurate for the client but does a check to ensure there is data in the required field.

4. Submit Claim to Clearinghouse - All Submitted Claims reside on the Submitted tab and are sent to the Clearinghouse once daily.
5. Check Claim Status - You will need to check your claims status with the Clearinghouse since TheraNest does not have access to this information for Non Apex customers.
   

   IMPORTANT: TheraNest is NOT able to see the status of your Claim , it is essential that you check on the Status of your Claims with the Clearinghouse.

Claim Rejected

If your Claim is rejected by your clearinghouse it will not be forwarded to the Payer. The process will stop.

IMPORTANT: Check with your clearinghouse for the reason the claim was rejected and then take necessary actions to correct and resubmit it in TheraNest.

1. Make necessary corrections in TheraNest and Resubmit if applicable.