This guide will walk you through the process of enabling the new claims export feature and explain what to expect. This feature is designed specifically for DocStation pharmacies that are members of the CPESN Medical Billing Support group who wish to share medical claims data via secure FTP with CPESN USA.
Enabling the Claim Export Feature
Follow these steps to enable the claim export integration:
Log in to your DocStation account
Navigate to Organization Settings
Select the Locations tab
Choose the applicable location for which you want to enable the feature
Click on the Data Exchange tab
Look for the CPESN integration section
If you haven't enabled the integration for eCare plans yet, select the CPESN integration from the blue + in the top right corner and click "Enable"
Find the Claim Export toggle button
Switch the toggle to the Enable position
Congratulations! You have now enabled the claim export feature for your selected location.
What to Expect
Once enabled, the claims export feature will automatically export adjudicated claims from the last 7 days. Here's what you need to know:
- Export Frequency: The export process occurs every Sunday
- Data Range: Only claims from the past 7 days are included in each export
- Automation: The export process is fully automated; no manual intervention is required
Automated Report Headers and Descriptions
claimId - DocStation claim number (ex: DS123456)
status - Adjudicated status of the claim (ex: paid, denied)
org - Name of organization
serviceLocationName - Name of location providing service
serviceLocationId - DocStation location ID
renderingProviderNPI - Rendering provider NPI
billingProviderNPI - Billing provider NPI
billingProviderState - State location of the billing provider
patientId - Subscriber ID on the claim
dateOfService - Service date of the claim
procedureCodes - Service codes billed (ex: 99605, 99212)
diagnosisCodes - Billable diagnosis codes identified (ex: Z23, I10)
modifierCodes - Modifier codes identified (ex: KX, 25)
placeOfService - Place of service identified (ex: 01-Pharmacy, 11-Office)
amountBilled - Total amount billed
amountPaid - Total amount paid
patientResponsibility - Portion of Amount Paid identified as patient's responsibility to pay
payerName - Name of payer identified (ex: Aetna, Blue Cross Texas)
payerType - Plan type (ex: Medicare, Medicaid, Other)
firstTimeReadyToSubmitDate - First time "Submit Claim" was clicked
sentToClearinghouseDate - Date the claim was sent to the clearinghouse
should typically be the same as the date the claim was submitted, but could be different if any of the following:
claim was initially "invalid"
transmission error occurred, delayed auto-submission
acceptedByClearinghouseDate - Date the claim was acknowledged by the clearinghouse
adjudicatedDate - Date the claim was fully adjudicated, per ERA
adjustmentReasonCodes - CARC to clarify payment details (ex: CO-19)
remarkCodes - RARC to clarify payment details (ex: CO-19)
templateName - Title of the claim template used to generate the claim
viaBinBilling - Whether claim was originated via BIN billing
docStationPayerId - DocStation's PayerID
clearinghouse - Clearinghouse to which the claim was submitted (ex: Availity, Change)
Troubleshooting
If you encounter any issues with the claims export feature or have questions, please contact our support team in Chat on DocStation or support@docstation.co.
Ensure CPESN - eCare Plans integration is enabled.
Ensure the Claim Export is enabled.
We hope this new feature enhances your experience with DocStation and simplifies your claims management process. Your feedback is valuable to us as we continue to improve our services.