Scrub claims first in the Claim Center, then open Process Claims. Choose a payer and clearing house, click Process. Pending claims are marked Submitted after the upload succeeds.
The Claim Center is the landing screen for all claims work. It lays the claim process out as four numbered steps: Scrub Claims, Process Claims, View Reports, and Reconcile Claims.
Scrub Claims is step 1. It is the first step in the billing process. Open the Claim Center from the ElderSuite main menu and click Scrub Claims to check claims before they are sent. How to Scrub Claims in ElderSuite covers that screen.
Process Claims is step 2. Open the Process Claims Wizard after the claims have already been scrubbed.
The Process Claims Wizard turns checked attendance into an electronic claims file, sends it to the chosen clearing house, and marks those days Submitted so the same day is not billed twice.
The wizard opens already on Select Payer. Choose the payer, the clearing house, the service dates, and the clients, then click Process.
ElderSuite gathers every attendance record in that date range for that payer whose claim status is Pending and that is not flagged with an error. It builds one electronic claim per attendance day, writes them into a single file with a batch control number, and uploads the file to the chosen clearing house.
Only after the upload succeeds are those records stamped with the batch control number and moved from Pending to Submitted. The wizard then closes and reports whether the billing went out.
Open the Claim Center from the ElderSuite main menu.
Click Scrub Claims. That button is step 1 of the claim work laid out on the Claim Center. Check the claims for the period you are about to bill, then return to the Claim Center.
How to Scrub Claims in ElderSuite covers that screen. This Guide picks up at Process Claims.
Open the Claim Center from the ElderSuite main menu and click Process Claims.
The Process Claims Wizard opens on top of the Claim Center, already showing Select Payer. Nothing on the Claim Center can be clicked until the wizard is finished or closed.
If Process Claims is greyed out, the signed-in user does not have the Process Claims permission.
Highlight the payer being billed. The list shows the center's active payment type names, without the entries named None and All. The chosen payer decides which attendance records this run picks up.
Click Continue. Highlight the clearing house that will receive the file. The list shows the center's active clearing houses. In this version of ElderSuite, electronic billing uploads only through a clearing house named Availity or TMHP.
The chosen clearing house must already have a server address, port, user name, and password on Manage Clearing Houses.
Click Continue.
Service Start Date and Service End Date arrive already filled with Monday and Friday of the current week. Leave them as they are for this week, or change them when you need a different range.
Tick Select All Clients to bill the whole center. The list is then greyed out so individual ticks cannot be changed until the box is cleared.
To bill only some clients, clear Select All Clients if it is ticked, then tick the clients you need. If you arrive with every client ticked and the list unusable, ElderSuite ticked Select All Clients for you because none were chosen on the previous page. Clear the box to start the selection over.
Only ticked clients have claims built for them, and only when they also have a Pending, error-free attendance record in the date range for the chosen payer.
Click Process. ElderSuite builds the electronic file and uploads it to the chosen clearing house.
If nothing in that payer and date range is Pending and error-free, ElderSuite reports that no matching claims were found and asks you to change the criteria or use Scrub Claims before continuing. Nothing is sent.
If Select All Clients is cleared and no client is ticked, ElderSuite asks you to select at least one client. The wizard stays open.
When the upload succeeds, the attendance records are stamped with the batch control number, moved from Pending to Submitted, and pushed into any open Scrub Claims, Reconcile Claims, and Meal Records screens. The wizard closes and reports that the electronic billing was sent successfully.
Cancel on any page closes the wizard at once. Nothing is processed and nothing is saved.
Process sends only attendance records whose claim status is Pending and that are not flagged with an error.
Electronic billing in this version of ElderSuite uploads only through a clearing house named Availity or TMHP.
The chosen clearing house must already have its server address, port, user name, and password recorded on Manage Clearing Houses.
Continue does not check that a payer or a clearing house has been highlighted. A missed payer usually shows up later as no matching Pending claims.
Ticking a client does not by itself produce a claim. That client must also have a Pending, error-free attendance record in the chosen dates for the chosen payer.
The wizard does not check that Service End Date is on or after Service Start Date.
Claim statuses are saved only after the upload succeeds. If the upload fails, the attendance records stay Pending and nothing has been billed. It is safe to try again.
If the upload succeeds but the status save then fails, the wizard still closes and reports that the process could not be completed. In that one case the claims may already be with the clearing house even though their status still reads Pending. Check the clearing house reports before running Process again.
For step-by-step assistance, click Ask Eddie from within ElderSuite.
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