NaviNet Clearinghouse Claims Creation & Submission – TherapyMate

This document will show you how to create and submit electronic claims that can be uploaded to the NaviNet Clearinghouse. (https://navinet.navimedix.com). If any portion of this information is out-of-date please the new information to us so we can update this article.

Clinician Practice Information Page Settings

Before you can create and submit a Clearinghouse Claim Files, you must make sure you have two fields set on your Clinician Practice Information settings. Click on your name in the upper righthand corner of the Dashboard and choose Settings from the drop down.

At the bottom of the Settings page you’ll see a link to Clinician Practice Information.

Click on the link and scroll down to the bottom of the Clinician Practice Information page. You will see two fields called Interchange ID Qualifier and Clearinghouse ID. Set them to the values shown below and save the page when done.

If there are multiple clinicians in your Practice, be sure to make these settings on each of their Clinician Practice Information pages if you want to bill through the same clearinghouse. Also make sure your practice address has nine-digit postal codes for your office locations and practice billing address. It isn’t necessary to have nine-digit postal codes for the patients themselves.

This completes the TherapyMate settings changes for NaviNet.

Creating a Clearinghouse Claims batch file

1. Click on the main Billing open at the top of your Dashboard shown on the next page:

2. Click on the Clearinghouse Claims tab as shown:

NaviNet Clearinghouse Claims Creation & Submission

3. On the next page you will see all of the Clearinghouse Claims that you have created in the past and submitted previously (see below). This page may be blank if you haven’t created any claims yet.

Please Note: Be careful not to delete claims on the mail Clearinghouse Claims page after you create them unless you have a reason to do so. When claims get deleted on this page the status of an invoice(s) will return to “pending” in the patient’s chart. If you need to make corrections to a batch you can delete the claim file, make the corrections in the patient’s chart and create a new version of the file. Otherwise, just let them accumulate so you can maintain a history of your claims.

4. To create a new Clearinghouse claim click on the + Create button as shown below:

NaviNet Clearinghouse Claims Creation & Submission

5. Check the boxes on the left-hand side for the claim(s) that you wish to include in the Clearinghouse batch file. For NaviNet, don’t mix different insurance providers in the same claim file. Each insurance provider has their own billing area. Please check with each insurance provider for more information about uploading claims. In the following example we are going to create and upload a claim for Aetna. Aetna allow claim files to be uploaded.

6. Click the blue “Select” button to create a Clearinghouse Claim file. You will be return to the previous page where your claim file will be located after it is created. Click on the floppy disc icon on the right to download the file to your computer. If the claim file doesn’t download, check you popup block in your browser’s settings to make sure it is turned off.

7. Log into Navinet and navigate to the area for your particular insurance provider. In the example below we are on the Aetna page. To upload a claim file that I created previously in TherapyMate, I select Claims and then Claim Submission from the menu options on the left.

8. Click on Claim File Upload as show above. Choose your claim file that you downloaded to your computer from TherapyMate and then click the Submit button to send the claim to the insurance company.

Checking Claim Status

If you wish to check the status of your Aetna claim, go to the Claim File Upload page again and you will see the various stages that the claim will follow. It is updated on a daily basis.

NaviNet Clearinghouse Claims Creation & Submission

When the payer acknowledged column changes from 1 to zero again, you can assume that the claim is getting paid. In a day or two check the site for an EOB.

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