Automated Claim Attachments
INSIGHT Billing can be used to submit Worker's Compensation (WC) and Motor Vehicle Accident (MVA) claims electronically through Waystar (formerly Zirmed). By partnering with our clearinghouse, claims and chart notes can be sent via EDI, eliminating the need to print and mail claims for WC and MVA payers.
Note: Automated Claim Attachments can only be enabled for Total INSIGHT or INSIGHT users who:
• Use Waystar (formerly Zirmed) as their clearinghouse
• Have the One-Click Claim feature activated
• Have the appropriate system properties enabled by Clinicient Support
If you are unsure whether you have the right setup to use automated claim attachments, please reach out to Clinicient Support.
Follow the steps below to set up automated claim attachments.
- First, make sure that worker’s compensation and MVA claims are set up correctly at the case level. Open the patient’s Client Editor and select Case Information F4.
- For WC, the Work Related Accident box must be checked and the patient’s employer must be entered. For MVA, the Accident Type must be set as Auto and the state where the accident occurred must be entered.
- To send WC claims electronically through Waystar, a social security number for the patient must also be entered in the Personal Information tab of the Client Editor. This is not a requirement for MVA claims.
- Next, a valid EDI number is needed for the WC or MVA payer. If no EDI number is shown on the patient's insurance card, call the payer to request their Payer EDI.
- Verify the EDI number is valid by going to the Waystar Payers tab. Under Claims Processing, enter the EDI number provided by the payer in the Ext Payer Identifier field and hit Search.
- Make sure that the correct payer is associated with the EDI payer ID. If no search results come up, the EDI number is either invalid or not recognized by Waystar. Reach out to Waystar Support for help.
Note: This is a specification set by Waystar for all WC claims, but if you are not comfortable adding the patient's social security number this requirement can be bypassed by entering 999-99-9999 in the SSN field instead.
- Once you know the payer's EDI number, you must also make sure that the WC or MVA payer accepts claim attachments through Waystar. Search Waystar's payer list here using the payer name or EDI number.
Note: You will need to continue printing and mailing claims for payers that do not accept claim attachments through Waystar.
- Once you've verified that automated claim attachments can be sent, open the Edit Payer profile for the payer in INSIGHT and go to the General Billing Data sub-tab.
- Under the Claims/Statements section check the boxes next to:
- Include Attachment Control Number (PWK Segment) in EDI Files
- Case Claim Number is Property Casualty Only (PCCN)
- Workers Comp – Use Employer As Subscriber
Note: Workers Comp - Use Employer As Subscriber should only be checked for WC payers. Do not select this setting for MVA or other litigation payers.
- Click Save and close the Edit Payer screen.
- Make sure to completely close out of INSIGHT, log back in, and double check settings before you bill.
Note: Activating automated claim attachments will only cause the system to attach chart notes to EDI claims. If the payer requires referral or authorization, that information must be faxed separately.
You can now bill claims electronically. After billing, INSIGHT users must log into Waystar and Name Match the payer to the correct EDI number. Notification should appear on the Waystar Dashboard stating Professional Claims Need Name Matching. step-by-step instructions for completing the name matching process can be found in Waystar's Eligibility Verification User Guide, located here.
- Payer Name Matching can be found on Page 28
- Provider Name Matching can be found on Page 29