Using the EDI Generator

Overview

The EDI Generator simplifies insurance claim submissions by automatically formatting your data into the standard electronic format required by clearinghouses. 

The EDI Generator lets you select charges on the nsurance Payments tab and create EDI files, which are formatted text files uploaded to clearinghouses to submit insurance claims.

Table of Contents

1. Before EDI Can Be Generated
2. How to Generate EDI
3. Common Error

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Details

Before EDI Can Be Generated 

1. Please email [e-mail] to ask the Cerbo Support Team to enable the EDI generator. When you email please let us know which insurance clearinghouse you will be using.
We cannot install the generator without this information.

2. The Insurance Companies that your practice is billing need to be entered and saved. There is an option under Admin > Manage > Insurance Companies to 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.

3. After adding insurance companies, select the patient's insurance on the Insurance tab in the Patient Information box in the patient's chart (click the pencil icon to edit). Ensure all patient details, including address and insurance info (primary and secondary if applicable), are entered to avoid EDI generator errors.

 

How to Generate EDI

To generate EDI, go to Reporting > Insurance Payments. Here, you can sort by patient name, date, or insurance payer, and filter by filed, paid, or unpaid charges.
Check the box to generate EDI for all charges in a soap note, specific charges, or all soap notes and charges shown on the page.

A pink box means missing patient info prevents EDI generation. Hover over the patient name to see the errors and fix them. An orange box indicates the soap note is unsigned.

Once everything is checked, you can click the Generate EDI button at the bottom of the page. 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’ll be prompted to save the generated file—choose a location you can easily find. Each clearinghouse differs, but usually, you’ll use the batch upload tool to upload this file, creating a batch of claims to send through your clearinghouse.

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Common Error

The EDI error "2400 LoopOccurence attribute is null" means the EDI generator found no valid service lines for the encounter.

Every charge line must meet all three conditions:

• Bill Insurance is checked
• Billing code is populated

• Charge amount is greater than $0. This includes anything under the "Manage How this Charge Displays on an Invoice"

  
   

More about EDI:https://www.edibasics.com/what-is-edi/