alloFactor: Medical Practice Scheduler, Billing, EMR Software & Patient portal

Electronic Claims
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Electronic Claims submission - Process

One time setup

1. Download and setup alloFactor if you have not already done so. You can start using alloFactor Calendar module to schedule patients and Claims module to create claims.
2. Login as admin and choose electronic claims option for the clinic. Ensure your clinic and provider details are complete including address, tax id, specialty information.
3. Next goto Contact module and map electronic payers to your clinic payers.
4. Our staff will do the necessary paperwork to complete setup. You can start submitting claims in 24-48 hours of signup.
5. Some payers (Medicare, Medicaid, Tricare, Railroad medicare and some BCBS) require enrollment to submite claims. Our staff will prepare necessary paperwork and email them to you for your signature. Review them carefully, sign in blue ink and fax/mail out based on instructions.

Claim submission

1. Create claim to submit using Claim tab under Claims module(for instruction on creating a claim, watch our flash tutorials under Help section)
2. Click on 'eFile' button on Reading Pane.
3. Claim is verified and submitted immediately to payer.

If we detect any errors before submission, alloFactor will immediately change the claim status to 'Claim rejected'. You can fix the claim in Claims tab itself and click 'File electronically' to resubmit it immediately. If a error is detected at clearinghouse end (usually within 10 minutes) the claim status is changed to 'Claim Rejected'

Exporting claims

1. Create claim to submit using Claim tab under Claims module(for instruction on creating a claim, watch our flash tutorials under Help section)
2. Click on 'Exports' option under 'eFile' button on Reading pane.
3. Save the print image on desktop and upload to your clearinghouse.