Kalix's batching feature allows you to export and submit multiple insurance claims at the same time. Kalix directly integrates with five different clearinghouses: Assertus, Availity, Claim MD, Office Ally & TriZetto via Secure FTP (or SFTP) for batch claim processing. Alternatively, you can manually export insurance batches from Kalix and upload them to your chosen clearinghouse's portal.
Clearinghouse Integrations
By using Kalix's clearinghouse integrations, you can submit claims to your chosen clearinghouses from within Kalix with a click of a button. Plus, you will receive back claim status updates, remittance advice, payment information, adjustments, and patient responsibility amounts without ever leaving Kalix.
There is no limit to the number of insurance bills that can be added to a batch. Bills in the same batch can be for different clients, different insurance companies, and different clearinghouses.
Creating a New Batch
Kalix directly integrates with five different clearinghouses to submit claims with a click of a button. Set up electronic remittance advice (ERAs) to receive back claim status updates, remittance advice, payment information, adjustments, and patient responsibility amounts without ever leaving Kalix.
1. To create a new batch, select Billing -> New -> Batch on the top header.
Ready to Batch
Claims must be assigned the status - Ready to Batch (as shown below) via their Billing payments screen will be added to the batch.
Note: Kalix automatically assigns this status to all new insurance bills yet to be added to a batch.
2. All insurance bills with the status - Ready to Batch will be listed on the New Batch page, with the exception of bills with critical errors.
Critical Errors
At the top of the New Batch page, Kalix will display an error message if there are any bills that have critical errors. Click on the View button to see the individual bills.
Bills with critical errors will not be included in the batch. The errors must be resolved in order for them to be exported.
Other Errors Notifications
When you create a Batch, Kalix will also display any error messages against each claim if certain information is missing. These errors will also appear on the bill after you save it.
These bills can be exported via a batch (unlike those with critical errors), but your Clearinghouse or insurer is likely to reject claims for these reasons, so it is recommended they are resolved before claim submission.
Fixing Errors (Critical & Other)
To fix the errors, click on the bill that has the errors listed, and the bill will open.
Select the Details section of the bill to edit.
Make your changes and save the bill.
Click on the Ready to Batch button again to return to the new Batch page.
For instructions on correcting billing errors, select the button below:
Filtering Claims
At the top of the new batches page are filter options allowing you to choose which insurers, providers, clearinghouses, and/or locations you wish to add to your batch.
Removing Bills From A Batch
If you wish to exclude any bills from the batch, just click on the cross can, as shown below.
The removed bills will be automatically added to the next batch you create.
3. When you are happy with the bills on your New Batch page, select the Create New Batch button at the bottom of the page.
4. The below alert will then appear. If you are ready to proceed, click Create.
5. Once the batch is created, you will see the list of bills included in the batch.
6. The next step is either to download the batch file and manually submit it or use Kalix's clearinghouse integrations.
7. Click the Send button to submit your claims to their assigned clearinghouses. Done!
Manual Batch Download
For manual batch download, select the download button, which is also located at the bottom of the page. Kalix provides you with three different download options:
1. PDF - Kalix will download the insurance claims on the traditional CMS 1500 formatted pages (with the red borders) for printing.
2. Print Only Data - insurance claims will be exported in a layout that can be printed on the official CMS 1500 forms.
3. 837P Format - the electronic format of the CMS 1500. If you manually export using this format, the file can be uploaded to the selected clearinghouse.
Note: 837P forms are specifically generated for a particular clearinghouse. Therefore, they cannot be uploaded to clearinghouses for which they were not created. The intended clearinghouse is listed in the option's name.
