Insurance Posting Guide

united health care sign into uhc website ( https //identity onehealthcareid com/oneapp/index html#/login user 1sthealth password (use current password for account) click the claims and payments tab click "search pra" type in date of eob (if checking everyday, just do a 2 day time span and all new ones will generate) hit pra hyperlink eob generates scan through eob's to see if they are high point or greensboro print off one's belonging to hp from there and post see instructions on posting payments if there are questions health network solutions sign into hnsconnect https //hnsconnect com/account/login user cmaysdc1 password (use current password for account) remittanes are generated every 10 days i e 30th or 1st of the month, 10th of the month, 20th of the month when checking for remittances hit "remittances" tab a list of remittances will pop up and you can click the newest one if it has not already been printed aetna sign into availity https //apps availity com/web/onboarding/availity fr ui/#/login user hstriad password (use current password for account) click claims and payments new eob's will automatically be generated if no eob's seen click on "remittance viewer" click the hyperlink box of eop/eob download eob click download in download folder scan through to make sure they belong to high point or greensboro ones belonging to high point get printed and posted generating edi claims while in rapid, click the "billing center" tab on the right hand side, there will be a list of options, click the "claim management" tab then click "process electronic claims" at the top of the box, there will be 2 options "start processing" and " claim preview hit the drop down box and there will be 2 different clearinghouse options "hns" and "waystar" uploading hns hit "hns" and then click "claim preview" from here the list of charges that have been posted for hns patients will generate go through and make sure all charges are posted correctly; correct modifiers for each charge, etc once you've scanned through all charges posted, click "start processing" once the claims have processed this can take a few minutes a box will pop up with 3 different options first, you want to download edi file, and then you mark file as "sent" from there you go into the folder where the edi files are generated make sure you are logged into hns website hit the "claims" tab at the top a drop down box will pop up and you will click "send claims" hit the "choose file" hyperlink and and choose the hns edi file that was just downloaded and then hit "upload" the edi file will then process; this can take a day or so typically if you login the next day, the file has been processed hit the claims drop down box and click "check status" a list of all edi files will generate and there will be a hyperlink in red if there are errors in your file that to be corrected and resubmitted if there is a error, you click the hyperlink and hns will tell you at the top what needs to be fixed they allow you to fix it on that screen whether it be incorrected id #, or missing group #, etc , fix the error and then press resubmit you'll want to check this again later to make sure the claim was fixed correctly uploading waystar process is the same as generating your edi file within rapid normally under these claims i'm checking to make sure there are no 97014 charges entered under uhc (waystar will deny this claims) your're also checking to make sure all charges contain the correct modifier medicare patients all have the at modifier, etc waystar website login into waystar once logged in, you want to make sure you're under the correct account there is a drop down box at the top with 3 options you want to be be under "health1st (170542)" from here, you will see a tool bar with hyperlinks click the "batches" hyperlink a list of all edi files from both greensboro and high point will generate there is a blue box on the left hand side that says "upload batch" this is how you upload the edi file same as hns click "upload batch" and search for your waystar edi file, and then hit upload / submit from there your batch of charges will be uploaded into waystar you will need to wait till next day (if uploading batches at the end of the day) to see if there are errors login next day and go back to batches if there are errors they will show as rejected if there are rejections, you can hit the blue hyperlink that has the # of claims that were uploaded once clicked, a list of all the claims will generate you will scroll the list and look for the claims in red which who they were rejected hold your mouse over the red hyperlink and there will be an error message that tells you what is wrong with the claim waystar does not let you fix the claim on their website like hns you will have to back to rapid, fix the charge on there and then resubmit back to waystar