PREPARATION
Log in to ImageNet claim entry with your Username and Password.
BEGIN ENTERING CLAIM
Select New Document from the options at the top of the webpage.
Select the provider you are entering a claim for under Providers.
Select DocType (claim form).
Select Create..
- NOTE: Provider’s Billing location information and Service location information (if applicable) will be inserted into the appropriate fields of the claim form. Please note that any changes to provider address information will update the record. The updated address(es) will appear the next time a claim is created for that provider.
Select the Plan Name you would like the claim submitted to from the drop down menu. Plan name will auto populate into appropriate fields on claim form.
Enter all required and applicable claim form information by clicking into each “Form Part” tab.
- Note: Only one Payer and Insured member may be entered on the UB claim form (boxes 50a-65a). For secondary claims only enter the details for the Payer the claim is being submitted to.
To add claim attachments, select the Attachments tab.
Select the file you would like to attach by clicking Choose File.
Once the file is selected select the Attachment Type.
- Select OTHER if the attached document file is supporting documents that do not contain EOB details. Attached PHI must only belong to patient on claim.
- Select EOB if the attached document file contains EOB details. Attached PHI must only belong to the patient indicated on claim.
FINISHING THE CLAIM
The entered claim can be saved or submitted.
- Select Save to save the claim. The claim will be saved in a folder and available to be edited and submitted at a later time using the “Edit DCN” link from your claim archive.
- Note: A minimum amount of data must be-entered to save a claim. Red notification messages will appear to indicate the fields requiring an entry. Saved claim renderings will not show data in fields. The data will appear once the claim is “submitted”.
- Select Submit once the claim is completed and ready for submission. Red notification messages will appear to indicate the fields requiring an entry. The claim will be available to view in a folder, and will no longer be available to be edited.
