New Clients - eCW Eligibility Config

eCW Insurance Configuration

  1.  Gather Client information from the Client Manager or DCS: 
    1. How many divisions the Client will need and what the names should be. 
      1. Example:   Bank of Oklahoma  vs  Bank of Oklahoma - HSA  OR  NextEra Kaiser  vs  NextEra BCBS  vs  NextEra Cigna
    2. Will the Client have an HSA or $0 claims? 
      1. If HSA, who is the Payer?
  2. Menu > File > Insurances > Insurances > New
  3. Complete the information as highlighted below.   The Payer and Eligibility IDs will need to be looked up via ClaimRemedi/eSolutions.
    1. Note: If the information is available, input the claims information in the address, phone, fax fields.
  4. Once created, provide the Insurance ID to the Client Manager to input into Company Hub. 

eCW Configuration for New Payers 

  1. Verify that the Payer is configured for ClaimRemedi/eSolutions by visiting the website > Enrollment Tab
    1. https://claimremedi.providersportal.com/default.aspx  
  2. If the Payer is not listed on the site, send an email to ClaimRemedi/eSolutions including the Payer Name and Payer ID.
    1. Andrew Garcia -  agarcia@esolutionsinc.com
  3. eCW > Menu > Billing > Miscellaneous Configuration Options > Configure EDI Receivers > Configure Eligibility Receivers
  4. Verify that the Payer is listed in the "Receiver Name" column. If it IS listed, click on the "Edit" icon to the right. If it is NOT listed, go to Step 5.
  5. In the Eligibility Receiver "Edit" window, do NOT edit anything. Click on Insurances Linked. 
  6. Verify that the Insurance is listed (AKA Company/Division). If it is not, click on "Add."  Select the appropriate divisions and click on OK. 
  7. To add a NEW Eligibility Receiver...   eCW > Menu > Reports > Report Console > Billing > Insurance Eligibility Adding New Payer Utility
  8. Type in the Payer Name and Payer ID. 
    1. Note:  Be specific here. Example:  BCBS Oklahoma  OR  Kaiser Northern CA 
    2. If the Insurance has already been setup with a Payer ID, it will automatically be configured per the above steps once the Receiver is configured. 

Update Schedule Jobs - Automatic/Batch Eligibility 

  1. Menu > Billing > PM Scheduled Tasks > Configure Insurance Eligibility Schedule
  2. Add the recently added Payer to the bottom batch. Click Ok.