ChiroUp Knowledge

Navigating EDI Activity

The EDI Activity page gives you a behind-the-scenes view of your electronic billing activity in ChiroUp. It provides a record of billing transactions, including when claims are generated and, for clinics using an integrated clearinghouse, what is sent to and received from the clearinghouse.

This page can help you track billing activity and understand what has happened with a particular claim or transaction.

🚀 Where to view EDI Activity

View EDI Activity under your main Billing module in the left-side navigation panel. 

🚀 What does EDI Activity Track?

EDI stands for Electronic Data Interchange. The EDI Activity log tracks electronic billing activity in your ChiroUp account.

Here’s a summary of the different types of EDI Activity logged on this page:

  • Claim Submission (837/CMS-1500): A claim (electronic/paper) has been generated in ChiroUp 
  • Remittance (835): An ERA (remit) has been received or uploaded into ChiroUp
  • Claim Acknowledgement (277CA): The clearinghouse has sent back a confirmation message that a specific claim(s) has been received
  • File Acknowledgement (999): The clearinghouse has sent back a confirmation message that a file itself has been received
  • Eligibility Request (270): An eligibility request sent to the clearinghouse. 

🚀 How should I use EDI Activity?

EDI Activity is a reference tool, not a page you need to routinely monitor as part of your billing workflow. Use it when you need to take a closer look at your billing activity, such as when troubleshooting an issue, verifying what billing activity has occurred, or gathering additional details about a claim or other EDI transaction.

EDI Activity also provides a high-level view of your billing activity, including the dollar amount billed on claims submitted and the dollar amount received through remittances within a specified date range.

Use filter options to narrow your EDI Activity search as needed! Commonly used filters consist of Date range, status, and file type! 

🚀 What do the statuses mean?

Each line item in EDI Activity will display a corresponding status. Here is what each status means: 

  • Generated: Applies to Claims and Eligibility Requests and means the record has been created in ChiroUp and is waiting to be transmitted to the clearinghouse.
  • Processed: Applies to all file types and means the file was successfully sent to or received from the clearinghouse.
  • Error: Applies to all file types and means something went wrong while the file was being processed. Retry any items with an Error status.
  • Rejected: Applies to Claims and Eligibility Requests and means the clearinghouse or payor rejected the item.
  • Duplicate: Applies only to Remits and Claim/File Acknowledgements and means the file matches one that was already received and processed, so ChiroUp did not process it again.

💡Pro Tip: Claims Submission Statuses 

  • Paper claims (CMS-1500): Claim Submissions will always remain Generated because paper claims are not transmitted electronically through a clearinghouse.
  • Outside clearinghouse: If your clinic uses an outside clearinghouse, Claim Submissions will remain Generated because ChiroUp does not transmit these claims to the clearinghouse.
  • Integrated clearinghouse: Claim Submissions will initially appear as Generated while they wait to be transmitted. Once the claims are successfully transmitted to the clearinghouse, the status will update to Processed.
    • This may take approximately 30 minutes because ChiroUp's clearinghouse integration runs at regular intervals. The exact timing depends on when your claim was submitted relative to the next interval.
    • If you use an integrated clearinghouse and your electronic Claim Submissions (837) remain in Generated status for longer than one business day, reach out to ChiroUp Support through your Support Hub for further troubleshooting.
 

🚀 EDI Detail

Click any line item in EDI Activity to view more details about the file, including the specific billing activity associated with it and any related patients, claims, dates, or other transaction details.

Here's an example of the EDI Detail for a Remittance file: 

 

 

 

 

 

 

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