Download Claim File to Submit Externally

Due to the ongoing Change Healthcare Outage that started on February 21st 2024, we have enhanced the Mark External Claims page to enable the ability to download 837/5010 claim files so they can be submitted through payer portals or another clearinghouse.

To get started, you will submit your claims electronically. Next, you will visit the Mark External Claims page and filter for Submitted Electronically. From there, you can download the associated claims for appointments. These claims will include all the dates of service and add-on codes that were included when you submitted the claim, so the download buttons for different service codes may link to the same claim. You will then mark the items as Externally Submitted, which will update the appointment and automatically cancel the claim so that it will not be submitted to Change Healthcare when their services resume.

Role Required: Practice Biller

Submit your Claims Electronically:

  1. To obtain the 837/5010 file, you will need to submit your claims electronically first.
  2. To view claims that are ready to be submitted: Click To-Do > Submit Electronic claims OR click Billing > Submit Electronic Claims
  3. On the Submit Electronic Claims page, use the Status, Payer, Clinician, Patient, and Appointments filters to find the specific claims you are ready to bill.
  4. Select the checkbox next to each appointment you're ready to submit claims for
  5. Click the Review Claim Details link and verify that all information on your claim is accurate
  6. Click the Submit Claims button.
  7. For more information, please see Submit Electronic Claims

How to locate your submitted claims:

  1. Click on Billing > Mark External Claims
  2. Click on Method dropdown and Select Submitted Electronically
  3. You can filter your search by Payer, Patient, Clinician and Date
  4. Click on Search

Downloading your claim file:

  1. For the resulting search on the Mark External Claims page, click one for each claim you want to download.
  2. If the submitted electronic claim contains multiple dates of service or add-on codes, then the 837/5010 data file includes all the items from that claim.
  3. A 5010 data file named with the corresponding claim number will be downloaded to your downloads folder as specified in your browser settings.

Mark Claim as Submitted Externally:

  1. Click Billing > Mark External Claims
  2. After you have submitted the line item manually via a method outside of TherapyNotes, click the Mark Submitted button next to the corresponding date of service.
  3. Once marked as Submitted Externally, the appointment will be marked as Submitted Externally, and the associated claim will be updated to a Cancelled status.

Submission Process:

Once the file is downloaded, you can upload the data to the payer portal or another clearinghouse. This allows for the external submission of your claims, ensuring continuity in your billing process.

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