Electronic Billing Receive Log Instructions

Use the Electronic Billing Receive Log routine to move the electronic billing transmission logs also called Receive logs from the download location to INSight.  The Receive Logs are confirmation files that show what the carrier acknowledges receiving during the e-billing transmission.  The Receive Logs provide an audit trail that you sent the electronic billing file to the carrier.  When the Receive Log routine is completed, you will use the Review Log routine to actually view the contents of the receive logs.

Notes:

• Each insurance carrier's receive logs have a slightly different format, but in general each carrier provides the following information:

• Acknowledgement Report or 997 Report - Reports whether the insurance carrier's electronic billing file as a whole is accepted or rejected.  The Acknowledgement Report interprets the 997 Report in a simple, easy to read format and tells whether the file has been accepted or rejected as a whole.

• Receive Log or Error Summary Report - Reports each claim in the electronic billing file and whether the claim is accepted or rejected and the reason why it was rejected.

• Little p Report - Reports information pertaining to your Medicare session and reports the number of claims they received.  This report only pertains to Medicare.

• Notes:  

• For Medicare only, if your e-billing session is successful there will be 3 reports.  

• For Mainecare, if your e-billing session is successful there will be 2 reports.  If the e-billing transmission was not successful there will be 3 or 4 reports.

• It is important to reconcile the e-billing journal with the receive logs to make sure the session completed successfully. To reconcile the reports:

• Compare the Control Number on the receive logs to Transaction Set Number on the electronic billing Print Journal.  They should match.

• Compare the grand total number of claims and the total charges amount on the e-billing print journal with the corresponding amounts on the Receive Log reports.  The receive reports for each carrier are slightly different and the grand totals for each carrier can represent something slightly different.  Depending on the carrier that you are currently viewing, the grand total number of claims can represent the number of batches in the file, the number of patients, the number of procedures, or the number of claims included in the file.  For example, for Medicare the number of claims equals the number of patients contained in the file.

• All rejected claims will need to be repaired.  For more information, see Electronic Billing Common Error Messages.

Directions:

To see directions for...

• Opening the Receive Log, click More.

  1.  Click Billing Functions from the Menu Bar.

  2.  Click Communications.

  3.  Click Menu Panel.

  4.  Click WEB MD.
  Note:  WEB MD is used as the carrier in the menu example.  Please select the appropriate insurance carrier name for your processing.

  5.  Click Receive Log.

   

  Receive Log Window Example:

  

   

• Choosing the Receive Log selections, click More.

   

  Electronic Billing Receive Log Instructions Prompts Tip:  To see more information about a field, click the hyperlink for the field name.
  Carrier Name	The Insurance Company Name displays for your reference.   Note:  It is important to confirm that you have selected the appropriate carrier for the Receive Log.
  Send Window Information	The following carrier information displays for your reference: Description - Carrier Code Description Carrier Type - Carrier Type which is used in the Send script Uppercase File - As specified by the Carrier Code Background Check - As specified by the Carrier Code Setup Sequence - the sequence number for the electronic billing session Transfer Sequence - The sequence number for the Transfer Send Sequence - As specified by the Carrier Code Last Date Transferred - Maintained on the Carrier Code Last Date Sent - Maintained on the Carrier Code Generated File Path - Carrier Code Transfer File Path Send File Path - Carrier Code Destination Path/File
  	To run the routine, click Proceed or press [ENTER]. Keyboard shortcut:  [ALT + p]
  	To escape from the routine without processing, click Cancel. Keyboard shortcut:  [ALT + c] Tip:  Or, click Close .
  Receive Log Processing	Displays information pertaining to the various phases of the Receive Log routine to guide you.  When complete the window displays Done.
  	To close the routine when Done displays and the routine is finished, click Done or press [ENTER]. Keyboard shortcut:  [ALT + d]

   

• Report Sample(s), click More.

   

  To see an example of the report, click Acknowledgement Report Sample.

  To see an example of the report, click Receive Log or Error Summary Report Sample.

  To see an example of the report, click Little p Report Sample.