Wanted to share a big update on the ClaimRev Connect module. If you've used it before, you might remember it as a basic claims submission and eligibility module — it could send claims and check eligibility from the patient dashboard, but that was about it. The eligibility checks got queued into a table and processed by a background service that ran every minute, so you'd sit there waiting for results to come back.
That's all changed. We've rebuilt and expanded the module significantly. Here's what it can do now.
Eligibility & Coverage Tools
Eligibility checks are now real-time. When you click Check Now, an instant call goes out and results come back in seconds — no more waiting for a background service to pick up your request. You can run checks right from the patient's Demographics screen or from the Appointments tab.
Available checks include:
- Eligibility checks (270/271) — get benefit details, deductibles, copays, and coinsurance back in real time
- Coverage Discovery — don't know who the patient's payer is? Coverage Discovery searches for active coverage and brings it back so you can populate the insurance card
- MBI Finder — look up a patient's Medicare Beneficiary Identifier without calling CMS
- Demographics verification — confirm the patient's info matches what the payer has on file
You can run these one at a time or check multiple products at once. Results come back in organized tabs — Quick Info, Deductibles, Benefits, Medicare, and Validations — so you're not digging through raw X12. There's even an AI assistant that lets you ask plain-English questions about the response, like "what's the remaining deductible?" or "is this patient covered for outpatient labs?"
Results can be synced to OpenEMR's native Insurance Card eligibility tab with one click, so the data shows up on the patient dashboard for everyone on the care team.
Appointments & Pre-Visit Eligibility
The Appointments tab pulls in your scheduled visits so front desk staff and billers can check eligibility ahead of time. See who's coming in, run eligibility right from the appointment list, and catch coverage issues before the visit — not after you've already submitted the claim. It's real-time, so you're always working with the latest information from the payer, not stale data from the last time a batch job ran.
Claims, ERA Posting & Payments
Beyond eligibility, the module now handles the full claims lifecycle — including posting payments directly into OpenEMR without leaving the module:
- Claims submission — submit 837P/837I claims through the OpenEMR billing manager
- Payment Advice & Posting — search for ERAs from ClaimRev, preview exactly what will be posted, and then post payments, adjustments, and denials directly into OpenEMR. You can post one claim at a time or batch post an entire ERA at once. Payments, contractual adjustments, and patient responsibility amounts all flow into OpenEMR's payment system automatically. Reversals and pended claims get flagged for review before posting so nothing unexpected slips through.
- Reconciliation — side-by-side comparison of what OpenEMR thinks vs. what ClaimRev shows. It automatically flags discrepancies like "billed in OpenEMR but not found in ClaimRev" or "ERA shows paid but no payment posted."
- Patient Balance — a queue of encounters with outstanding patient responsibility after insurance has responded, with statement tracking and a breakdown of why the patient owes (deductible, coinsurance, copay)
- Claim Status — work-queue dashboard with real-time 276/277 status checks
Analytics
Under the Analytics dropdown you'll find:
- AR Aging Report — 30/60/90/120+ day aging by payer with CSV export
- Denial Analytics — spot patterns in adjustments and denials by reason code, payer, and monthly trend
- Recoupment Report — tracks Medicare reprocessing and payer take-backs. Shows the original payment, the recoupment, whether a reprocessed payment has come through, and the net impact. Handy for keeping on top of those Medicare reversals.
All three reports export to CSV for further analysis.
Everything is Searchable
Pretty much every screen in the module is built around search. Claims, payment advice, reconciliation, patient balances, eligibility history — you can filter by patient name, date range, payer, status, and more. You're not scrolling through lists hoping to find what you need.
Compatibility
- Works on OpenEMR 7.x and 8.x (built-in compatibility layer handles the differences)
- Requires PHP 8.2+
- Free module — just needs a ClaimRev account for API credentials
How to Get It
Download and installation instructions are on our documentation site: https://docs.claimrev.com/doku.php?id=openemr_manual
Install is straightforward — upload the zip through Modules > Manage Modules, enable it, and run the database upgrade from the Setup tab. Takes a few minutes.
If you don't have a ClaimRev account yet, reach out to us at sales@claimrev.com or visit claimrev.com to get started.
Happy to answer any questions here or at support@claimrev.com / 918-942-9564.
Brad Sharp
ClaimRev
Kidding, nice work…