FAQ and Additional Information

frequently-asked-questions

What claims and EDI formats do you support?

P2E is Eagle Innovations’ solution for converting paper claims (HCFA, CMS-1500, UB-92, UB-04 and Dental) to EDI X12 4010, 4010D, 5010, or 5010D (837p, 837i, etc.)

P2E supports all dental and major medical paper forms using ICD-9 and/or ICD-10 codes. It creates standard (EDI X12 4010, 4010D, 5010, 5010D) files as well as any custom format you may require, including proprietary formats, NSF, custom XML and more.

Can we maintain physical control of our claim files?
If you want to maintain physical control of all of your claim files after scanning, then you would need to purchase scanning equipment. In this event, Eagle’s IT staff will be more than happy to assist you by working with your team, and our equipment vendors, to find the perfect scanner for your claims volume.

Can my company outsource our mail entirely – i.e. opening, preparation, and scanning?

If your company receives paper claims and does not want to handle opening, preparation, or physical document storage in-house, Eagle can perform 1 of 2 functions:
1.) You can send your organization’s files via Fedex or UPS, etc. to Eagle. Once Eagle Innovations receives your claim files we will begin opening, preparation, and scanning. All queue work will be visible through Eagle’s web portal.

— or —

2.) We can set up a post office box with the U.S. postal service that would automatically forward to a P.O. Box in Dallas, TX. You would give that address out to your clients. We would pick up claims daily and process them.

 

When could we begin using P2E if we want to outsource all of our paper?

You could be processing paper to EDI claims as early as tomorrow. The P2E process is as simple as setting up your account. After an account is established, you can begin sending claims. In order to set-up an account with Eagle today, please contact one of our team members at:
Ph: 214-237-3870 ext 301
Email: sales@eiimail.com

Can the documents sent be returned?

Yes, the documents can be returned to a location of your choice – i.e., your office or a storage facility where you store your claim files.

 

Can Eagle Innovations store our claim files?

Yes, Eagle Innovations can store your claim files for a monthly fee (first three months are included at no charge; after that we can continue to store them or we can securely shred them).

 

When could we begin using P2E, if we decide to do the scanning in-house?

If you already have the appropriate scanning equipment, you could start tomorrow.

 

Other Tools and Functionalities

 

Web Portal Access to Your Claims, Statistics, and Reporting Tools
After you have an established account with Eagle, you will receive instructions for logging in to Eagle’s web based portal to access the system. Eagle’s web based portal will allow you to view and retrieve any claim image. It also provides access to all of your company related data – i.e., shipping history, work in progress, indexed and stored claim files; and, all of your organizations statistics for managing your daily operations. The data stored by your organization will remain on our system for a period of 10 years.

 

Provider Mapping

Many TPAs and Health Plans are struggling with the pervasive industry problem regarding Provider IDs.

P2E Provider Mapping intelligently manages the tough challenges in processing your paper claims and mapping the provider data on the claims to provider ID # in your system. When claims are processed P2E learns how you match data to the correct provider number, saving your company countless hours of labor and claim errors.
Provider Mapping… A Closer Look at the Advantages

Eagle developed a methodology to handle a problem that plagues the “payer industry”. That is, determining from a claim, which provider number this claim should be associated with in your adjudication system. Have you ever had a claim resembling the following:

TAXID: 123456789
Billing Entity: ABC Providers
Rendering Location: Doc-In-A-Box, Tempe AZ
Rendering Provider: John Doe
At this stage your system would assign a provider number to use within your adjudication system…the problem is that with paper, this number is not present (and according to many of our clients, even when presented via an EDI file, the number is very often incorrect). With Eagle’s provider mapping feature this problem is easily resolved, and inbound provider data is normalized to your system’s expectations.

Storage and Indexing

With P2E your facilities paper claims will be stored and indexed. Online access to your claims information can be retrieved at any time by via Eagle’s web portal (included at no cost with all P2E implementations.) Records, attachments, and even images are kept for 10 years.

Reliable 24/7 Server Access

Multiple servers running with backups and re-routing – always access! You will never have to worry about access being lost from our servers being down.

 

Statistics to Measure Performance

At no extra charge, Paper to EDI (P2E) allows you access to your inventory, statistics, and turn-around reports.  You can look up any claim at any time for up to 10 years. Eagle’s system will store all of your data for a 10 year period. Your claims can be found in the system by searching for any relevant item associated with the claim.

Security

P2E’s Web Portal uses a strict whitelisting methodology, ensuring that no computer will have access to your data without speficic authorization.  You cannot access your data unless the IP address of the computer you are trying to connect from has been set-up as being allowed.