Workers’ comp claims have a few extra moving parts. You often need the right payer code, a correct claim type, and an attachment that actually follows the claim all the way to the payer. This tutorial walks you through the full process in Medisoft and eMEDIX so your claims submit cleanly the first time. If you don’t have eMEDIX yet, you can learn more about how Medisoft EDI can streamline your billing process here.
Quick note: We are not certified billers and this article is not legal or payer compliance advice. Always verify requirements with each payer.
What you will do in this workflow
- Find the correct workers’ comp payer code on the eMEDIX Payer List.
- Configure the insurance carrier in Medisoft with that code and the correct claim type.
- Complete the patient case with the EDI report fields and policy details payers expect.
- Submit the claim in Revenue Management, then attach and transmit supporting docs in eMEDIX Online.
Step 1: Look up the workers’ comp payer on the eMEDIX Payer List
Go to the site online.emedixus.com/payer-list and look up the Insurance. Use the eMEDIX Payer List to confirm:
- The payer code for workers’ comp
- The transaction format you will use: Professional vs Institutional (codes can differ)
- Whether Unsolicited Claim Attachments are supported Electronic or Not Available
Why Unsolicited Claim Attachments matter: The payer code and attachment method determine how Medisoft and eMEDIX route your claim and whether the attachment goes electronically or gets dropped to paper with a print fee.
Tip: If Electronic is not available, confirm the payer’s mailing address and keep it updated in Medisoft. That is where the attachment will go if the clearinghouse drops to paper.
Step 2: Set up the insurance carrier correctly in Medisoft
Open Lists → Insurance Carriers, then locate the insurance carrier you want to edit or create it if not already there.
Once within that specific Insurance Carrier, you will need to go to:
- EDI/Eligibility tab
- Receiver: Typically EMCL for eMEDIX Claims
- Payer ID: Paste the workers’ comp payer code you found
- Carrier EDI Settings → Type: Select Workers’ Comp for workers’ comp claims
- Address tab
- Enter the correct mailing address for the payer. Critical if attachments are not electronic.
Why this matters: The claim type and payer ID tell the clearinghouse how to format and route the file. A wrong code or type leads to rejects or misrouted claims.
Step 3: Complete the patient case so attachments match the claim
Open Lists → Patients/Guarantors and Cases, choose the patient, and open the Case used for these dates of service on the right side.
A) Diagnosis tab → EDI Report section
Fill the three fields the clearinghouse reads:
- Report Type Code: Common example is OZ (Support Data for Claim). Confirm with the payer.
- Report Transmission Code: Example EL for electronic. If the payer drops to paper, you may use BM by mail.
- Attachment Control Number: Use the exact file name you will upload to eMEDIX, like 123ABC.pdf.
Tip: If you don’t know what codes to use, you can find examples of codes in Medisoft. Click on Help on the right-hand side, scroll down to the tabs and click Diagnosis, then scroll to find the title EDI report. Below EDI report you can find links for both Report Type Codes and Report Transmission Codes, that can give you lists providing those codes.
Why this matters: eMEDIX matches your uploaded attachment to the claim using the control number. If the name does not match, the attachment will not pair with the claim.
B) Policy 1 tab → workers’ comp specifics
- Insurance: Select the workers’ comp payer
- Policy Holder: Use the employer’s name, not the patient
- Double check within your policy holder name for the employer, under Entity Type that Non-Person is selected.
- Relationship to Insured: Employee
- Claim Number: Enter the property and casualty claim number provided by the employer or carrier
- Then hit Save.
Why this matters: Workers’ comp claims often reject when the employer is not set correctly as the policy holder or when the entity type is left as Person.
Step 4: Submit the claim in Revenue Management
Process the claim as usual in Medisoft Revenue Management. Once exported and sent to eMEDIX, you will finalize attachments inside your eMEDIX Online portal.
Step 5: Upload and transmit the attachment in eMEDIX Online
In Claims Connection → Workspace, filter to find the claim by date and open it.
- Go to the Attachments tab
- In Unsolicited Payer Claim Info, pick the Attachment Control Number that matches the file name you put in the case
- Then scroll to bottom to where you can attach a file, Browse to the document on your computer and Submit Attachment
- Click Transmit to send the claim with the attachment
What to expect: If the payer supports Electronic unsolicited attachments, eMEDIX delivers it electronically. If Not Available, the clearinghouse prints and mails the attachment with the claim to the payer address you set in the carrier record.
Common mistakes that cause rejections
- Using the claims payer ID instead of the workers’ comp payer code
- Forgetting to set Type = Workers’ Comp in Carrier EDI Settings
- Mismatch between the Attachment Control Number in the case and the actual file name you upload
- Leaving the Policy Holder as the patient instead of the employer
- Not switching Entity Type to Non-Person for the employer
- Missing or wrong property and casualty claim number
Quick checklist for your team
- Payer code verified on eMEDIX Payer List
- Unsolicited attachments method confirmed (Electronic or Not Available)
- Medisoft payer set with correct Receiver, Payer ID, Type = Workers’ Comp
- Payer address added and current
- Case EDI Report fields filled: Report Type, Transmission Code, Attachment Control Number
- Policy Holder set to Employer, Entity = Non-Person, Relationship = Employee
- Property and casualty claim number entered
- Claim submitted in Revenue Management, attachment uploaded in eMEDIX, then Transmit
FAQ
Do I use Professional or Institutional?
Match what the payer expects for this plan. Codes can differ. Confirm on the eMEDIX Payer List and with the payer if needed.
What if the payer list says Not Available for unsolicited attachments?
Your claim still goes electronically. The attachment will be printed and mailed by the clearinghouse, so keep the payer address correct in Medisoft.
Which report codes should I use?
OZ and EL are common examples, but always verify with the payer. Medisoft’s Help shows the full code lists inside the Diagnosis tab.
Need help?
If you want us to double check your setup, map your top workers’ comp payers, or sit with your team and run a test claim, AZCOMP Technologies can help. We can review your Medisoft configuration, confirm eMEDIX settings, and train staff on a clean, repeatable workflow. Not using Medisoft EDI yet for your clearinghouse? You’re missing out. Medisoft EDI is the perfect companion for Medisoft and makes submitting claims faster, easier, and far more reliable.
Ready to make workers’ comp claims straightforward for your team?
Contact AZCOMP Technologies and we will get you set up the right way.
About AZCOMP Technologies
AZCOMP Technologies is the #1 Medisoft dealer in the nation, trusted by more medical practices than any other Medisoft partner. Since 2000, we’ve been helping independent practices streamline their billing, improve patient collections, and get the most out of their software. From expert Medisoft support and training to full-service revenue cycle solutions, we’re here to make your practice more efficient, profitable, and stress-free.
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