The EDI generator allows you to select charges on the Billing > Insurance Payments tab and create EDI, which is basically formatted text in a specified format, which can then be uploaded to insurance clearinghouses to create insurance claims:
Before EDI can be generated a few things need to happen:
1. The Insurance Companies that your practice is billing need to be entered and saved. There is an option under Admin > Manage > Insurance Companies where you can enter this information.
When entering an insurance company, you can look up the insurance company payer ID. There is a link in the add window where you can look these up.
2. Once insurance companies are added, each patient for which insurance will be billed needs to have their insurance company selected. This is done on the Insurance tab, under the patient edit box form. (click the pencil icon in the Patient Info block on the pts chart). Also, it is VERY important that all information for the pt is entered or the EDI generator may throw an error. This includes all patient address information, insurance info, and secondary insurance info if applicable.
3. With all of this set, you can generate EDI from the Billing > Insurance Payment tab. On this screen, you can sort by patient name, date, and insurance payer, or filter by filed, paid, or unpaid charges. To generate the EDI, you can click the box to generate EDI for all charges in a soap note, specific charges, or the box to generate EDI for all soap notes and all charges for those soap notes that are displayed on the page. If a box is pink (as shown in the screenshot below) this means some information is missing for that patient and EDI can not be generated for them. To see the errors hovers over the pt name and a message will pop up showing what information is missing so you can correct it.
Once everything is checked, you can click the "Generate EDI" button at the bottom of the page, and this will send the information to the EDI generator, which creates a .txt file with the date it was generated.
Once this button is clicked, an alert box pops up asking if you would like to mark the files they are sending to the generator to be marked as "filed". This is for internal tracking of what charges have been submitted for insurance reimbursement. If you click "Ok" it will mark them as filed. If they click "Cancel" they will not be marked as filled. Either way, the edi file will get generated.
You will then see a prompt about where to save the generated file. Save this somewhere you will be able to easily find it when you upload it to your clearinghouse. Each clearinghouse is different, but for most you will want to find the batch upload tool and upload the file you downloaded. This will create a batch of claims to be sent out through your clearinghouse.
More about EDI: https://www.edibasics.com/what-is-edi/