eSolutions is fully integrated with TotalMD, so it literally takes but a click of the mouse to send the claims to eSolutions once you have validated them in TotalMD. However, there are many features of eSolutions to be used. Note that by the time you are ready to use the features below, Technical Support will have already assisted you with the setup and configuration.
eSolutions is unique among popular clearinghouses in that it comes as a companion application rather than as a website. This means it can be navigated quickly and even allow for multitasking. Once you sign into the eSolutions claims screen, you will see the Task Manager screen, which we’ll cover later in this document:
You will then want to select the Menu drop-down and go to the Claims Manager screen:
Your screen will initially look like this:
This is a detailed search so you can search for claims however you like. For now though, you can leave this section blank and choose to Select Claims to see all of the claims and responses that are in your system:
You will then see your claims. For the purposes of demonstration, one claim has been chosen to show the different reports that can be returned:
Once you have highlighted the claim in the top panel, the list of reports associated with this claim show up in the bottom panel:
By right-clicking on any given report, you may see these any of these options:
By clicking View Status Message, it will show you the message attached to this action. By clicking on the top response for this claim, you will see this report that came from eSolutions:
This is a 999 response:
This is a report that actually came from the payer:
This is a status report that is an ERA:
This is what that actual ERA/EOB looks like below when choosing View EOB Standard Remittance, as above:
There are other reports, but they are similar and accessed in the same ways.
You can change the status of a claim manually by right clicking on the status of a given claim:
After clicking on Change Claim Status, you will be able to select the status you want to be reflected in eSolutions:
Any of the fields at the top of the claims can be used to sort the claims, such as provider, payer or place of service:
In the drop-down created when right-clicking on the claim in the top panel, you will see many choices, one of them is eligibility:
Any payer with a green E beside it, you are able to check real-time eligibility.
This is a representation of the report that is returned by the clearinghouse for eligibility:
These are other screenshots of the information returned:
eSolution’s eligibility report is much easier to read than other clearinghouse reports.
By right-clicking on the claim in the top panel, you can search for similar claims:
Again, right-clicking will give you to option to create claim letters:
These are the different letters you can choose:
As an example, here is the Claim Adjustment Letter:
The other letters are similar, just for different purposes.
Choosing to View Inbound File and Preview Outbound will both show you the actual ANSI file.
If you are looking at a secondary claim, you can click View COB Summary:
This is the report that is generated:
You can view the progress of a claim by right-clicking on any report in the bottom panel to get this pop-up:
You will then see a list of all the actions that have been taken regarding this particular claim:
By selecting certain claims, you can print, move the claims to ready status or scrub them.
Moving back to Task Manager, let’s look at creating and using Tasks. When entering Task Manager, you will see a list of existing Tasks. If you are new to eSolutions, you may not have any Tasks, or very few Tasks. As you become more familiar with eSolutions, you will develop reports specific to your use of the system.
To create a Task, you will choose to Add Task:
You will then be able to choose the drop-down to look at the types of Tasks that you can create:
This is the screen you would see to create a Claim Task:
By running this report, we see a list of secondary claims that have been sent:
By clicking on any given claim, you will see the same reports you see in Claim Manager:
By clicking on the ERA line, you will get the same ERA report that you get in Claim Manager:
Basically, once you run the report, you can do all the functions in the Task than you can in Claim Manager.
If you have questions regarding this functionality of TotalMD, please contact our support or training departments at 800-613-7597 Option 2 for Support or Option 3 for Training. If you would like a printable copy of this document, please contact the Training Department.