How To: Import Claims and Assign Audits

Claims that are uploaded into the system, are pre-populated into the audit box, rather than having to enter the claim data manually. This can be a huge time saver. In a few short steps, claims can be uploaded and assigned to their appropriate audit, within the system. Navigate to the 'Import Claims and Assign Audits' page within Audit Manager, and follow the steps below.

Article Sections:

• Creating the claims upload file
• Importing the claims upload file
• Tips and Common Issues Resolution

Click on a section above, to jump there.

Creating the claims upload file:

Step 1.
Determine if your auditee is a provider or a coder.

Step 2.
Depending on Step 1, download the corresponding 'Provider & Practice List' or the 'Coder & Organization List' both found above the Upload Instructions in the upper right section of the Import Claims and Assign Audits page.

How To: Import Claims and Assign Audit Image 1.

Step 3.
Providers and coders must be loaded into the system, prior to importing claims for them. Review the corresponding downloaded file and verify the providers or coders you will be importing claims for, are in the system. If they are not, add them via the Manage Lists and Client Lists page before continuing.

Step 4.
Download the 'Audit Data File' found on the upper right-hand area of the Import Claims and Assign Audits page.

How To: Import Claims and Assign Audit Image 2.

Step 5.
Populate your claim data into Audit Data File you downloaded; required fields are marked with an asterisk(*).
Note: Do not change or move any columns in the Audit Data File as this will cause an error upon uploading.

Step 6.
Title your file and save it to your computer as a .csv file, where you can access it.

Importing the claims upload file:

Step 7.
If you have already created the project you will be uploading the file into, skip to Step 8 below. If you have NOT created the project, do so now (see Manage Projects).

Step 8.
Follow the steps below to upload the claims file into the system.

1. From the Import Claims and Assign Audits page, select the 'Audit Project' dropdown, then find and select the project you want to import the claims into.
2. Click 'Upload Document' to select the file with the claim data you created in Steps 1-5 of Creating the claims upload file.
   Note: A window will open to locate the file on your computer.
3. Find and select the file you have loaded claims into and click 'Open'.
4. Optionally change the Due Date, and select an Auditor and/or QA Reviewer to which you want to assign the audits.
5. Click the ‘Submit’ button.
   
   How To: Import Claims and Assign Audit Image 3. 
   Note: After clicking 'Submit', Audit Manager will begin processing the file. In the table at the bottom of your screen the name of the file will appear, and you will see 'In Process' displayed in the Upload Status column. The system is checking to make sure the data is valid, i.e. the DOS is not in the future, column headers are correct, etc.

Step 3. 

1. If there are no errors identified in the data, you will see "Complete" in the upload status column. This process is complete.
2. If data errors are identified, you will see "Cancelled. Errors found" in the upload status column. Continue below.
   
   How To: Import Claims and Assign Audit Image 4.

To view the errors in your file, follow the steps below.

1. Click the download icon to the right of the errors file, and open the file in Excel on your computer.
2. Scroll to the farthest column to the right and locate the added column titled ‘Validation Errors’.  Any rows in the file that have errors, will have a message describing the error on that row. We recommend fully expanding the column to read the entire error.
   Pro Tip: Most of the errors are in the first few columns of the data. It may be helpful to temporarily hide some columns to reduce scrolling. Just be sure to Unhide the columns before submitting the file for upload again.
3. Fix all errors in the data. (See Tips and Common Issues Resolution)
4. Delete the entire 'Validation Errors' column with the error messages.
5. Save the file to your computer with a new name and continue to Step 10 below.

Step 10.
Repeat Steps 8-9 until you have successfully uploaded the file.
Note: You may choose to keep the listed files as a record of claims upload history, or delete them by clicking the X to the right of the download icon.

Tips and Common Issues Resolution: 

1.  It is essential that providers and practices from the Provider & Practice List, or the same from the Coder & Organization List exactly match their corresponding entries in the Audit Data File. Records that do no match on providers or coders in the system cannot be uploaded. Extra characters or spaces will prevent the file from uploading successfully.

2.  If you do not have a Provider ID associated with a provider, you can use Provider Name. However, once a Provider ID is associated, you will be required to use the Provider ID for claims import.

3. Before uploading the claims data the system the file is checked for errors in the data.  This ensures that only validate data is uploaded to the system.  The error messages are displayed in the last column after all the data.  The error messages will explain what needs to be corrected on each row.

4.  If there is an error on a file but the download file icon does not appear, try clearing your browser’s cache, close the browser completely, reopen the browser, log into Audit Manager. This frequently this resolves the problem.