MedClaimsIQ Tutorial

This guide explains how billers and RCM teams can analyze ERA and claim status files without clearinghouse portals or Excel work.

Step 1 — Upload EDI File

Upload your ANSI X12 file (835 ERA or 277 claim status) directly from your computer.

  1. Go to Upload X12 page
  2. Select your ERA or 277 file
  3. Click Parse
Supported files: 835, 277CA, 277 Claim Status

Step 2 — Review Parsed Claims

After upload, MedClaimsIQ automatically extracts:

  • Patients
  • Claim numbers
  • Payers
  • Service lines
  • Paid amounts
  • Adjustments (CARC/RARC)

Open Files → Details to inspect each claim.

Step 3 — Generate Posting Batch (835)

Automatically create a posting sheet ready for PM system posting.

  1. Open the ERA file
  2. Click Generate Posting
  3. Use it for payment posting
Eliminates manual Excel posting logs.

Step 4 — Check Claim Status (277)

The 277 file shows claim acceptance or rejection from clearinghouse or payer.

  • Accepted
  • Rejected
  • Pending

Go to 277 Status page to filter by payer or rejection reason.

Step 5 — Denial Management

MedClaimsIQ groups denials automatically using CARC and RARC codes.

  • CO-45 Contractual adjustment
  • PR-1 Deductible
  • CO-16 Missing info

Visit Denials page to see top denial patterns.

Step 6 — Aging & Work Queue

Track unpaid claims and follow-ups automatically.

  • 0-30 days
  • 31-60 days
  • 61-90 days
  • 90+ days

Use Aging and Work Queue pages for daily follow-ups.

Summary

Workflow:
Upload → Review → Post → Track → Fix Denials → Get Paid

MedClaimsIQ removes clearinghouse dependency and turns EDI files into actionable billing data.