Clearinghouse integration simplifies your workflow by automatically submitting and receiving claims within ChiroUp—no more manual uploads or downloads!

When switching, you may encounter orphan claims. An orphan claim is an ERA response for a claim that either didn’t originate in ChiroUp or couldn’t be automatically applied to the original claim for various reasons.

Where can I view Orphan Claim Responses? 

Orphan claims can be found at the bottom of their corresponding ERA. In this example, the ERA only contains one claim response, which is the orphan claim you see in the orange box. 

You can also view your Orphan claims in the Orphaned Claim Responses tab under Billing. 

Working an orphan claim in one location will also update it in the other. 

Orphan claims fall into one of two categories:

Type 1: Claims from your prior EHR: 

• These responses are linked to claims that originated in your previous EHR system. To identify them, check the date of service. If the date is before your ChiroUp Go-Live, the claim came from your prior system. These are the most common type of orphan claims.
• If you've identified that the claim does not need to be in ChiroUp, you can click Ignore.
• If needed, you can manually post this ERA in your prior system. We recommend using your clearinghouse to access any adjudication information required.

Type 2 - Unmatched Responses in ChiroUp: 

• These are responses that ChiroUp couldn’t automatically match to an existing claim. 
• Common causes of this type of orphan claim include ERAs for Medicare secondaries, where Medicare forwarded the claim but the secondary claim was never created in ChiroUp. This can also occur when an ERA is received with different payor or patient information than what was sent the original claim.
• To work this type of orphan claim, we recommend first checking the patient's record for the date of service to ensure a claim is created. 
  • If you don’t see a claim for the patient’s date of service—such as when Medicare forwards to a secondary that wasn’t added in ChiroUp—you’ll need to create the secondary policy and attach it to the purchase.
  • Next, go to the Invoices tab in the purchase and open the secondary claim. From here, generate the claim, making sure to toggle OFF electronic billing so it is not sent to the clearinghouse. This will create a paper claim in a Submitted status, allowing you to “adopt” the orphan claim.
• Once you've confirmed there is a Submitted, Received, or Reprocessed claim to apply the orphan to, you can click Adopt. 

• This will open a screen where you can search for the payor name and ‘adopt’ the claim. 

• Once successfully adopted, you can proceed with posting as normal