claims training guide - cca medical training manual.pdf · 4 proprietary information to see all of...

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Claims Training Guide

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Last Revised on 6-13-2007 10:50:00 AM

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�Welcome ......................................................................................................................... 3 Rejected Claims Dashboard............................................................................................ 6 Claims ............................................................................................................................. 8 Editing Claims ............................................................................................................... 13 Working Claim Rejections ............................................................................................. 16 Batches ......................................................................................................................... 20 Payers ........................................................................................................................... 22 Reports.......................................................................................................................... 23 Frequently Asked Questions ......................................................................................... 32 Quick Reference to CMS WEBSITE.............................................................................. 32

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Welcome �

Go to Account | Welcome screen. The Welcome screen is the first screen after logging into the system.

The Welcome screen will display links to other information on the ZirMed Web site. Look for updates in this area for the latest information on additional services and products offered by ZirMed. The Welcome screen also includes the following: Action Items This section contains a summary of rejected claims. You will see a link with the total number of rejected Professional or Institutional claims and you will see a link for the Rejected Claims Dashboard. The Dashboard will let you view your rejections in a variety of ways to help you quickly fix your claims and resubmit. Alerts - Under Alerts you will see links to messages that fall into the following categories:

• General Alerts – Messages from ZirMed regarding system status, application updates, training notification, production issues, scheduled down-time, payer issue, etc.

• Payer Updates – Payer specific information (e.g. new Payers or changes to existing Payers, deletion of payers) will be posted here.

• Enrollment – Enrollment activation or de-activation notifications.


To see ALL of your old Alerts again, click on Include Read and click .

*Please be sure to read all Alerts posted.

Alerts are used by ZirMed to notify of things happening with your account, with payers and with the ZirMed enhancements.


Things to Remember Do you have enrollments pending? If Yes, it is very important for you to go the Prof Claims or Inst Claims tab and select the Enrollment tab. Check to see if the provider number we are enrolling is accurate. If it is not correct please let the CCA team know immediately.

Who do you call when you need help? CCA Medical Support Note: The CCA Team Has extensively tested the files with ZirMed. If you are having issues with claims it will save you time to contact the CCA support services to correct any issues that arise. Note: The ZirMed Support Representative will contact CCA before attempting to fix any claims issues. Calling CCA first will save you time!


Rejected Claims Dashboard

The link will take you directly to the Rejected Claims Dashboard, and will display all currently rejected claims for your account. (NOTE: Rejected claims will remain on the Rejected Claims Dashboard until they are corrected and resubmitted or hidden.) When you first go to this screen your rejections will be grouped by rejection message. You can change the way the rejected claims are grouped by selecting a different grouping category from the drop-down list and clicking on You can separate any group of claims into smaller groups by selecting one of the grouping categories in the Drill Down column and clicking on The link in the Qty column will take you to the Claims screen, and display the claims for that particular error. You can then Edit and resubmit or place notes to be worked at a later time. HELPFUL HINT: Many people like changing the Group By to “Payer”

Change the Group By to: Rejection Source Rejection sources can be

• Payer • ZirMed • Intermediary


Resubmit: The Mass Resubmit screen will let you resubmit all claims in that group. You can use this feature after the reason for the rejection has been corrected. For example, if the claims rejected because Payer enrollment had not been completed, once enrollment is completed you can Mass Resubmit.

(See the Rejected Claims Dashboard under REPORTS for more details on this screen.)


Claims Go to Professional or Institutional Claims | Claims screen. The claims screen eliminates the need for claims reports. Claims can be displayed for up to two years on the ZirMed site. The claims status will change as responses are received from the Intermediary, from the Payer and from ZirMed. For the purpose of this training document, the screen below reflects the Professional Claims tab. Most of the functions described are available under the Institutional Claims tab. The Institutional tab has the same sub-tabs under it as Professional Claims. Throughout this manual, we will reference the Professional Claims tab.

Search Claims You may fill-in any box in Search Claims then click on the Search button to display your search results. Available search options:

• Patient – Patient name submitted with the claim. Search by Last name, First Name or any part of first name or last name.

• Trans Date(s) – Date last processed through ZirMed default selection is to display 6 months, dropdown to display 2 years

• Payer – dropdown box allows the user to choose between the ZirMed Payer name or My Payer which is the name submitted with the claim

• Claim Number – Patient control number submitted with the claim, this is the patient account number found on your practice management system

• Rendering Provider (Attending Provider for UB) – Provider name submitted with the claim as the provider performing the service

• Service Date(s) – Date of service submitted with the claim


Search Claims, cont’d Beside the search button is a More link • Sequence – Primary, secondary or tertiary claim for the last instance of the claim

are represented by the numbers 1,2,3. • Source – Represents the method the claims was transmitted to ZirMed • Status – Status code assigned to the claim by ZirMed or the payer response file • Transaction Date(s) – Date last processed through ZirMed • Specify claim allows the user to search for a specific claim.

Instance ID – ZirMed ID assigned to claim each time it is processed Claim Prefix – Assigned to claim by ZirMed to link EOB to specific claim

Rejected Claims Dashboard This is a link to the Rejected Claims Dashboard (see Reports) Old Claims Screen For a limited time ZirMed users can switch their display back to the one line format. This is during an interim period while changes are being developed and tested for the claims screen display. Please feel free to provide feed back to our development team regarding your likes and dislikes. We are a “Yes, We Can!” company and we listen to all our feedback. The ZirMed development team updates our site approximately 4 times per year with enhancements that come from our users. Click the link at the bottom of the claims screen to provide feedback to both the claims and batches screens. User Preferences Users can set and save their preferences for the claims screens.

Many Users prefer to show “All Claims” when they first start using ZirMed Claims screen. The default is “Rejected Only”


Status (Claim History) You can click the link under the Status column for any claim on the Claims screen. The Claims History screen will display all of the events events related to this claim in chronological order. This screen can be printed and submitted to the payer as proof of timely filing by clicking on File and then clicking on Print. The top section of the screen has a link to Copy info above to clipboard.which allows the you to paste pertinent claim information info an email to notify your CCA Support Team about issues with this particular claim. The middle section of screen will display the date and time of each submission of this claim and provide a paper version in both the Old Form (HCFA) and New Form ( CMS-1500) formats. These forms are displayed in Adobe format and can be printed or saved to your computer. ZirMed will maintain claim history detail for 2 years. After 2 years the claims will be archived and can only be retrieved by submitting a request to the ZirMed Support Team.


Edit You have two choices for editing your claims, Edit and Old Edit (Old Edit is located under the More… link. The difference is that the Edit screen has additional boxes and fields that are not on a paper claim, which may be needed for electronic filing. (Note: Editing claims will be discussed in more detail later in this document.) Note Users can add notes regarding this claim. Notes are displayed in the Claim status history window and the last note is displayed on the claims screen along with the date and user that created the note. To add a note Click Note, type your message and press the Add Note button. If you would like to hide the claim at the same time you add a note, simply check the “Also hide claim(s) when adding note” box before clicking the Add Note button. More… Additional action items are available as follows: Hide Why would you hide a claim? Once a claim is sent to ZirMed it cannot be deleted. If you receive a rejected claim from a payer because it was a duplicate claim, you can hide the duplicate. To view a claim once it has been hidden simply change the Hidden status dropdown to “Include Hidden” or “Hidden Only” and press the search button to refresh the screen. Hidden claims will show user who hide the claim and the date and time it was hidden. Hiding a single claim:

• Press the More… link • Press the Hide link • The claim is immediately hidden

Hiding multiple claims: • Check the box(es) on the left side of the screen next to that claim’s submit date • Click Hide link at the bottom of the screen

You can always un-hide a claim by pressing the More… link, then selecting Un-hide link or by checking the box(es) on the left side of the screen next to that claim’s submit date and clicking the Un-hide link. 2nd

If this feature is enabled the user can create a secondary claim. (see Secondary claims training guide for more details) This is available for professional claims only.


View (displays the most current version of the CMS-1500 form)

The View button displays a claim for you as it would print on a CMS-1500 form using Adobe Acrobat Reader. You can then print this form. Note: Some payers require a signature. Some payers require an original paper claim, and will not accept a claim printed from this screen. You should first confirm the payer's acceptance policies. For a minimal fee, ZirMed can arrange to have your claim printed and mailed to the payer. View using old form


Editing Claims The Edit screen is the HIPAA-ready Claim Edit Screen. This screen accommodates all of the fields and field values in the HIPAA claim transaction. To edit a claim, click on the field you need to change, enter the required information, and then click on the Save and Resubmit button located in the upper left corner. Note: The Edit screen has additional boxes and fields that are not on a paper claim, which may be needed for electronic filing. Use the Old Edit only when the error is simple and straightforward. The Old Edit Screen is in the form of a CMS-1500 Professional Edit Screen The Professional Claims Edit screen is divided into five different views.

• Simple View – displays the typical fields found on a paper claims. This view is used for simple, quick edits.

• Claim Detail View – displays the claim level information • Insurance View – displays the insurance subscriber information and additional

insurance information needed to process the claim for secondary claims • Service Line View – displays the service line detail information


Institutional Edit Screen (UB-92) The Institutional Claims Edit screen is divided into five different views.

• Claim Detail View – displays the claim detail information • Insurance View – displays the insurance subscriber information and additional

insurance information needed to process the claim for secondary claims • Service Line View – displays the service line detail information


Important things to remember about the Edit screens:

� Required fields are displayed in bold text. � Clicking on the field will display help in the information area on the left side of the

screen. � If the field displayed is highlighted in pink you will not be allowed to change to

another view without first correcting this field. � Folders within the Edit views are sometimes displayed with just the heading and

a ( + ) plus sign. Clicking on the plus sign will expand the folder and display the associated fields.

� Folder display defaults can be changed by clicking on Settings on the Edit screen and selecting “Full” (always display as open) , “Heading” (display heading only), “Hidden” (do not display folder).

� The rejection message will display in the upper right hand corner. The source of the rejection will be included at the end of the rejection message within square brackets [ ].


Working Claim Rejections The Rejected Claims Dashboard is the preferred method for working rejections messages. There are three ways to reach the Rejected Claims Dashboard:

1) From the Welcome screen under Action items 2) A link located at the top of the Claims screen 3) From the Reports tab under Prof Claims or Inst Claims

This link will take you directly to the Rejected Claims Dashboard where you will see the rejection messages. (More information regarding the Rejected Claims Dashboard is found in the reports section of this guide.)

� Read the rejection message carefully. Look for keywords, rendering, claim detail, service line etc.

� There can be more than one rejection within the message.

� Many rejections messages contain the location of the invalid data

within the ANSI 837 file. The information will be seen within square brackets and will help your CCA Support Team locate the problem within your CCA software or the file format. A common example would be [2010BA, NM109] Member ID contains invalid data.

� ZirMed validates CPT, ICD-9CM and Zipcode


Enrollment Rejections: CLAIM REJECTED BY SECOND EDITS<BR> ENROLLMENT FOR PROVIDER NUMBER (########) FOR PAYER ID XXXXX (PAYER NAME) HAS NOT BEEN COMPLETED AND PAYER DOES NOT ALLOW PAPER CLAIMS WITHOUT ORIGINAL SIGNATURE. PROBLEM: ##### represents the legacy provider number submitted on your claim. XXXXX (PAYER NAME) represents the Payer ID and Payer Name which your are trying to bill. This rejection message is stating that the provider number on the inbound file did not match what ZirMed has on file on the enrollment tab or the enrollment has not been activated by the payer. RESOLUTION: Check your enrollment tab. Go to Prof Claims or Inst Claims

Enrollment tab – you should see a provider number set for the payer referenced in the above rejection message (payer is listed next to ORGID). Look for the number set up on the enrollment table. You will want to: 1. Populate your practice management system with the correct provider number for

that specific payer. 2. Perform one of the following:

• Edit the claim online, enter the correct provider number and resubmit the claim.

• Enter the correct provider number in your practice management system, “hide” the claim on ZirMed and resubmit from your practice management system.

Invalid Data Rejections:

CLAIM REJECTED BY SECOND EDITS <BR>HEALTH CARE DIAGNOSIS CODE(S) (3460) IS INVALID. MUST BE A VALID DIAGNOSIS CODE FOR THE DATE ON WHICH THE SERVICE WAS PERFORMED. [2300-HI] PROBLEM: In this example diagnosis code 346.0 is invalid for this date of service. ZirMed has partnered with the AMA to provide the most current ICD-9CM and CPT code validations for our customers. RESOLUTION: The claim may be edited online.

1. Go to Edit Simple View or Old Edit to enter the corrected diagnosis code. Verify that the diagnosis pointer is correct. The diagnosis pointer indicates that the service line directly relates to that particular diagnosis.

2. Correct the diagnosis code in your CCA Software.


REQ: RENDER NETWORK ID FOR PAYER. RENDER ID - PROV ID INVALID FOR PAYER.

PROBLEM: The payer is indicating that they require the rendering doctor to submit the provider ID assigned by the payer. RESOLUTION: The claim may be edited online.

1. If you have the provider ID you may edit the claim online in the provider’s view of the edit screen, save and resubmit.

2. Be sure to enter this provider ID in your practice management system as well to prevent future rejections.

Note: If you do not have the provider ID you will need to call that specific payer to obtain it. Check the ZirMed Payer list for notes regarding this payer and the payer ID requirements. Most Common Rejections by Payer Railroad Medicare (SRRGA) RENDER PROV# NOT MEMBER OF GRP LISTED-HL=2 REF-02. RENDERING PROV NOT A MEM OF GRP - HL=2 REF-02. PROBLEM: The payer is indicating that the rendering provider is not linked to the group number submitted for the billing provider. RESOLUTION: Contact CCA Support Team for enrollment. Railroad is assigning a 6 digit alpha numeric group number and rendering providers will be linked to that group number. Medicare B Georgia – AL BCBS (SMGA0) INVALID PROV # : 1 IN LOOP 2310D PROBLEM: The payer is indicating that the provider is invalid in Loop 2310D. RESOLUTION: Loop 2310D is the Service Facility Location.

1. Edit the provider ID in the provider’s view under Service Facility provider of the edit screen, save and resubmit.

2. Be sure to enter this provider ID in your practice management system as well to prevent future rejections

BC/BS of North Carolina (SB810) CODE: P006 SEGMENT NAME: SUBSCRIBER NAME NM1-09 INCORRECT DATA: 017PH 2010BA-NM1-09 (member ID will be here) EXPLANATION: MEMBER ID MUST BE VALID. (VALID ID IS AN EXACT REPRESENTATION OF THAT ON THE MEMBERSHIP ID CARD). PROBLEM: This is actually two different errors. First the subscriber name is incorrect according the payer records. The second error is the member ID is invalid. RESOLUTION: Verify the patient’s insurance information

1. Edit the subscriber information on the simple view or the insurance view, save and resubmit.

2. Be sure to correct the subscriber information in your practice management system as well to prevent future rejections.

United Health Care (87726)


Note: compare these two different messages ACKNOWLEDGEMENT/RETURNED AS UNPROCESSABLE CLAIM-THE CLAIM/ENCOUNTER HAS BEEN REJECTED AND HAS NOT BEEN ENTERED INTO THE ADJUDICATION SYSTEM. SUBSCRIBER AND SUBSCRIBER ID NOT FOUND ACKNOWLEDGEMENT/RETURNED AS UNPROCESSABLE CLAIM-THE CLAIM/ENCOUNTER HAS BEEN REJECTED AND HAS NOT BEEN ENTERED INTO THE ADJUDICATION SYSTEM. SUBSCRIBER AND SUBSCRIBER ID MISMATCHED PROBLEM: This two errors appear very similar but need to be worked differently. The key is at the end of each message. The first message the “Subscriber and Subscriber ID not found” means the UHC could not find this subscriber OR subscriber number in their system. The second message the “Subscriber and Subscriber ID Mismatched” means that UHC had either a different name or a different subscriber ID in their system. RESOLUTION: Verify the patient’s insurance information

1. Edit the subscriber information on the simple view or the insurance view, save and resubmit.

2. Be sure to correct the subscriber information in your practice management system as well to prevent future rejections.


Batches Go to Professional or Institutional Claims | Batches screen.

The batches screen will show the number of claims submitted, the number and dollar value of the claims processed. When you click on the status message you will see the breakdown of this batch and how many claims were rejected or hidden. This number is updated as claim responses are received from the payer. Note: The number of discarded claims should always equal zero. If you see any other value please contact the CCA Support Staff. �

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Common Batch Errors “Error during batch processing” is an error that could occur, it may mean that the file you created was not a good claim file, or at least not in the format that we were expecting it to be in. “Error: Duplicate batch detected” is an error which means that the file you just uploaded was an exact duplicate of a previously uploaded file. You should go back to your practice management system and go through all the steps to recreate the file. You should be able to do this without re-keying the claims. “Error: During X12 batch processing” is a file level error that prevents the file from even being uploaded. A cause for this error would be a problem with the integrity of the file. (e.g., the file was missing the submitter id, or data was missing that is required in the 837 Companion Guide.)

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Contact CCA Support Team if you receive a batch

processing error!


Payers Go to Professional or Institutional Claims | Payers tab. This screen will let you search the following:

• Which payers can accept electronically filed claims through ZirMed.com • Which payers require enrollment before accepting electronically filed claims • Payer IDs used for Name Matching

All information on this screen is maintained by ZirMed. Under Search For - you have the capability to search for a payer by using either the Name or Payer ID Number. The Type category also allows you to narrow the search by choosing the payer type from the drop-down box (e.g. Commercial, Medicare, Medicaid, Blue Cross/ Blue Shield, etc.). If you cannot locate a payer on this list, the Payer may still be able to accept electronic claims. You can verify this by contacting the Payer directly and asking if they accept electronic claims. If they do, ask them for their "Electronic Payer ID". For those payers who cannot accept an electronic claim, ZirMed can create a paper claim and mail it to the Payer on your behalf set the payer ID to 98999.

Name Matching Note: CCA customers should never have to Name Match. If you receive an error for Name Matching, begin by checking the payer list to determine the correct Payer ID. Correct the Payer ID on the ZirMed edit screen and then correct the payer in the CCA software.


Reports Go to Professional or Institutional Claims | Reports screen. Select the report you want on the left. The Reports screen gives you the opportunity to print reports as specific or as general as you may need.

Claims Billing Report The Claims Billing Report is a two step process that first produces a summary of all claims received by ZirMed within a given date range. You may select one of the pre-defined Date Ranges or you may create a Custom range. If you are a billing service (i.e. submit claims for more than one facility), you can further specify a facility by keying in all or part of the facility's name. Leaving this blank will display all facilities' data. You can also specify if you want the totals for Electronic and Paper to be separated or combined. Additionally, you can specify the sort sequence (i.e. domain by payer, domain by account, or domain by account by payer. Once you have specified your search criteria, click on Submit. A new window will appear, showing the number of claims based on the search criteria entered. There may be differences between the total number of claims from this report and the total number of claims from the Claims Summary Report for the same period. This is because the Claims Summary Report total reflects the number of claims, whereas the Claims Activity Report total reflects the number of times a claim is submitted and resubmitted. This report includes resubmitted claims. NOTE: These claims may still have been rejected by the payer.


Rejected Claims Dashboard

This report displays (non-hidden) currently rejected claims, and allows you to select how you would like to have them grouped. It can be accessed from links on the following screens:

• Account | Welcome • Prof Claims | Claims • Inst Claims | Claims • Prof Claims | Reports • Inst Claims | Reports

When you first enter this screen the default Group By is Rejection Message and will include Name Matching Rejections. This view will display your currently rejected claims sorted in descending order by the number of claims that rejected with the same rejection message. You can change your primary Group By, by selecting one of the following from the drop-down box then clicking on the Go button.

• Batch • Billing Provider • Facility • Payer • Rejection Date • Rejection Message • Rejection Source • Rendering / Attending Provider


Rejected Claims Dashboard, cont’d For each line displayed in the lower section of the screen, there will be additional links which can be used to help you work that group of claims.

Qty – Clicking on the underlined number will take you to the Claims screen and display claims matching that grouping. Drill Down - This is a drop-down box where you can select an additional breakout of that group of claims. The drop-down options here are the same as the Group By options above. After selecting one of the options, click on the Go link. The screen will refresh and display only that group of claims broken out by the option you selected. You can select up to three (3) Drill Downs. Each time you select a different Drill Down and click on Go, the screen will refresh, and also display a tree of the selections you specified with a description of the group selected. These descriptions become links, which when clicked will take you back to the previous view. There will also be a Start Over link, which will take you back to the original screen display. Example: Group By “Rejection Source”, Drill down by “Payer”, then Drill down by “Rejection Message:

Action – If you have selected “Rejection Message” in either your Group By or Drill Down selections a Resubmit link will appear in the action column.


Expanded Rejection Analysis The Expanded Rejection Analysis report is a summary of all claims that have ever rejected, regardless of their current status, sorted by either the Message or by the Payer. If a claim was rejected by ZirMed, and you filter by Payer, those claims will not display. Using this report can help your practice identify and correct problem areas such as: consistent data entry errors; needed updates for your Practice Management System; changes to ZirMed’s system set-up; or individuals who may benefit from additional training. The date range entered will select claims based on the date ZirMed first received the claims. Under the Additional Criteria section, you can further refine your search by entering certain keywords, by specifying the minimum number of times a rejection occurred, or by including (excluding) hidden claims. HELPFUL HINT: Print this monthly as part of your month end routine and review for recurring errors.

Hidden Claims The Hidden Claims Report will list those claims currently with a Hidden status. The date range entered will select claims based on the date ZirMed first received the claims. The claims display in descending Submit date sequence (i.e. most recent claims first). It will also display the status and text of when the claim was hidden. Under the Additional Criteria section, you can further refine your search by entering certain keywords.


Hidden Claims, cont’d If you see a claim on this report that should not be hidden:

• Go to the Claims tab • Search for the claim (be sure to check "Include Hidden" in your search criteria) • Remove the Hidden checkmark for the claim • Click on Save Hidden Status

This will help you monitor what claims specifically have been hidden; it should be printed regularly.

Discarded Claims Since ZirMed only notates that a claim was matched to Discard Claims, and does not keep the claim, this report will display information on those claims. If a claim was matched to “Discard Claims” in error, you will need to:

• “Un-Match” the Payer, in Name Matching (Show Matched Names) • Regenerate the claim from your Practice Management System • The claim will now reject for Name Matching • Match the rejected claim to the correct payer • Resubmit the claim

CCA customers should NEVER have discarded claims. Please contact your CCA Support Team if you see discarded claims within your Batch Status or this report.


Claims Summary This report will give you a current snap-shot in a summary format of all claims submitted to ZirMed for a given date range. From the drop-down box you can choose the sequence of the report by selecting Batch ID, Date, or Payer. After specifying the Date Range, click on Submit and the report will appear in a new window. In addition to showing the total number (and amount) of claims, this report also shows the number (and amount) of claims currently rejected, hidden, and submitted to Payers or Intermediaries. Since it reflects the current status of a claim, resubmitted claims show only one time. There may be discrepancies between the total number of claims from this report and the total number of claims from the Claims Activity Report for the same period. This is because the Claims Summary Report total reflects the number of claims, whereas the Claims Activity Report total reflects the number of times a claim is submitted and resubmitted. NOTE: Only original submissions will appear on this report.

This report should be printed monthly to show your totals for the month.


Claims Number Cross Reference Some Payers’ remittances show only the ZirMed transaction ID (Prefix) along with all (or a portion) of the patient’s account number. This report will allow you to match the ZirMed transaction ID to your internally assigned patient claim number so the payments can be applied to the correct patients’ accounts. Each time a claim is submitted to ZirMed for processing, a unique identifier is assigned to the transaction. This identifier should be used to identify claims in order to properly post payment and adjustments to the patient's account within your Practice Management System. This report can be created for all Payers within a given date range, or, by selecting a single Payer from the lookup menu, it can be Payer specific. The "New Instance ID" will be the number appended to the beginning of your Patient Account Number. Only print this as needed.


Rejected Claims for any Batch Name This report gives you a listing of current rejected claims and lists the rejections by payer. You will see the patient information specific to each claim and most importantly this report is printable. Print this as needed.

Payers Matched to Paper This report displays all Payers you currently have payer name matched to paper within the ZirMed system. This report should be reviewed periodically to ensure Payers who can accept electronically submitted claims are updated. Use the Name Matching for Payers screens to enter these updates.


Detail Reports The Detail Report feature allows you to choose a number of report options in order to create a report that best suits your current needs. From the Detail Report screen you can select the sort sequence and date range. Under Additional Criteria, you can request if rejected and in-progress claims should show; and how much detail to display for each claim (events, Payers, and Provider information). By supplying information in the Filters section you can further reduce the number of claims displayed on this report. This report will have 3 sections:

• Rejected Claims- This section will show the detailed information for each claim and exactly why it was rejected.

• In-Progress Claims-This section shows the detailed information for all in-progress claims.

• Rejected & In-Progress Claims- This would include both types.

Note: If under Additional Criteria you have selected Rejected Claims Only or Rejected & In-Progress Claims, you must provide a Batch ID.


Frequently Asked Questions Q) How can I check to see if my claims went through? A) After you have uploaded your claims, you will notice in the Batches screen under Status “Processing Complete”. This indicates that your claims file has been processed. You can then click the Claims button on the right to check the Status of the individual claims. Q) How do I hide multiple claims? A) Go to Professional Claims/ Claims, then check the box on the left side of the claims screen, then click the Hide link at the bottom of the screen. You can also un-hide a claim by clicking on the More Actions… link and selecting the Un-hide option. Q) How do I get my account unlocked? A) If you mistype your password 3 consecutive times your account will be locked. The password is a case sensitive field; it gives you an error check your Cap Locks. You must have call CCA Support Desk by calling (800)775-2553. Q) How do I check the status of enrollment? A) Go to Professional Claims, then the Enrollment tab. This screen will tell you if any payers are waiting on enrollment to be completed. It will tell you the Status of a payer’s enrollment and the Phase. Q) How can I get a report / list of my claims submitted to ZirMed? A) ZirMed tries to provide you with the tools to be a paperless billing entity. Claims can be listed, viewed and printed from the claims screen one page at a time. The printer icon located on the left corner of the claims list will display the list in an HTML format and you can then select File and Print.

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