Workers Comp and Jopari Electronic Attachments

Workers Comp and Jopari Electronic Attachments


Attach Documents using the Claim Attachments Link

Create a Manage Services Ticket for Jopari setup and activation of this feature.

The Electronic Document attachment works independent of a connection to an EHR/EMR, but does require the use of Jopari.


After activation, you can manually upload an attachment to the Encounter.

  • The PWK segment is added automatically to the 837.
  • The filename links the attachment to the Claim.
  • The Claims File Indicator (CFI) on the Insurance must be WC.
  • The Electronic Attachment is sent to the Clearinghouse when the Claim batch is uploaded.


Attach the Document

  1. To add documentation on the Encounter Dashboard, select the Add link in the Claim Attachments panel.

  1. Choose Type from the dropdown.
  2. Description: Optional field used to identify specific documents.
  3. Select the File to attach.
  4. Send on Claim: Selected by default.
  5. Select Save [F2].


Claim Attachments Panel


In the Claim Attachments panel, details of the attachment can be viewed and changes can be made.

  1. Modify icon: Select to make modifications to the Type and Description.
  2. Attached: Date the Document was attached
  3. Type of Document attachment.
  4. Description of the Document.
  5. Claim File Name
  • The File Name is the Tax ID_Patient Encounter_DOS_Document number. The Document number is in the order the Document was attached.
  • File Name example:
  • 230000000_10111E78945_20220125_1
  • 230000000_10111E78945_20220125_2
  1. File Extension
  2. Upload Status
  • The Attachment will be sent to the Clearinghouse when the Claim is Uploaded.
  • Uploaded is indicated by an upload date.
  • Not uploaded is indicated by a red X.
  • The PWK Segment is added automatically to the electronic 837 claim file.
  1. Send on Claim: Determined by the Send on Claim checkbox.
  2. View column
  • Select the Open link to view the Document.
  • Select the Delete link to remove the Document.
  • A Document can only be Deleted if it has not been uploaded.
  1. Select the Print icon to print the attachment.
  • The Print icon only appears when the attachment is a PDF or an image.


Modify the Attachment Type and Description

  1. In the Claim Attachment panel, select the Modify icon .
  2. Make your changes.
  3. Select Save [F2].

Prevent an Uploaded Attachment from Sending on the Claim

If an Attachment should not be sent on the Claim, deselect the Send on Claim checkbox.

  • In the Action column, choose the Open link.
  • Select the Print or Save icon on the opened Attachment to print it for a paper claim or to save locally.


Policy Requirements

  • Insured Relationship MUST be 20.
  • The Employer must be added to the Employer/Attorney Library as TypePolicy Holder Only.
  • The 2010CA will only show on the electronic claim if the Insured Relationship is 20.


Insurance Library Requirements

The Jopari Payer IDs are preceded by JOP.

  • Using the Clearinghouse Payer List, select Jopari ONLY.
  • Add the Payer to the Insurance Library by selecting the checkbox and then select Add to Insurance Library or add it manually.

  • If the Payer could not be found, use JPRINT as the Claims Payer ID and choose HCFA for all Form Types. These will be printed locally with manual Attachments.

 


Tags

If you have a claim that needs an attachment that is not yet available, you can use a TAG to hold the claim.

Example: Waiting on documentation.  This holds the claim until the documentation is available and the claim is ready for submission.


Local Edit, Clearinghouse, and Payer Rejections

Clearinghouse Rejected [CE]

ReasonJopari requires the patient (dependent) loop on all claims.

Fix: Update the Relationship to 20 and resend the claim.

 

ReasonJopari Workers Comp Claims require a Related Cause Indicator on the claim.

Fix: Add the Accident Date/Related Cause to the claim and resubmit. In the example, it is added on the CASE.

 

Payer Rejected

  • Requests for additional Information/Documentation or Requests for additional supporting documentation.
  • Examples: Usually this pertains to a second attachment request for certification, x-ray, or notes.; Supporting documentation. Usage- At least one other status code is required to identify the supporting documentation.;-OZ Support Data for Claim-;
  • Process: Resend the claim with the corrected attachment.



For Internal Use: Add ENCATTACH.





    • Related Articles

    • Jopari Rejections

      Rejection: Jopari Requires the Patient (Dependent) Loop on all Claims The Client has signed up for a third-party Clearinghouse, Jopari, who handles electronic Workers Compensation Claims, and this Claim is missing the Policy Holder relationship 20 - ...
    • Add a Case for Workers Comp

      Workers Compensation Case Cases allow specific information for repeated Charges and Appointments per patient. Workers Compensation Policy The Insurance Profile for Workers Comp should be added first. See Workers Compensation Policy Profile. Add a ...
    • Report on Specific Patient Types

      You can report on Patients in a specific category using several methods. Categories Examples: Medicare Patients Medicaid Patients Diabetic Patients Worker's Comp Patients Auto Accident Patients Reports The Custom Patient Query can be used to create a ...
    • Add a Workers Compensation to Insurance Library

      Workers Compensation Payers are added to the Insurance Library. Insurance ID: The System will auto create this field unless you have chosen to add your own in System Defaults. Insurance Name: Enter the Workers Comp Insurance Name. Abbreviation: Enter ...
    • Manually Batch and Upload Electronic Claims

      Electronic Claims can be manually batched and uploaded. Ideally, you will want to use the Job Scheduler to create and upload your batches, but there will be instances where you will need to use the manual batch and upload method. Go to the Claims ...