Summary: To submit claims electronically, you need to have Insurance Features enabled on your account, review your Insurance settings, add Payer IDs to your payers, and begin Enrollments. You may also need to customize some settings for different payers or practitioners. You may need to wait a few weeks for your enrollments to be completed.
Once your account is setup for electronic claims, you may begin submitting them to payers where you are enrolled through our clearinghouse.
You may initiate an electronic claim a couple of ways.
The most common way is to navigate to Clients> [Client Name] > Billing > Documents. Click New... and select Claim.
Create a New Claim
Select services
Note: Eligible services are services from previous sessions that have not already been submitted as electronic claims that also include insurance-reimbursable CPT codes. You may submit claims as an in-network or an out-of-network provider.
You may also create an electronic claim from a relevant bill by clicking on the Create Insurance Claim button.
Note: If you find yourself changing information here often, you may need to setup a customization for a payer and/or provider.
Verify the claim information
You may edit the billable services including modifiers, any co-pay / co-insurance amount, the location, and the diagnosis.
Edit Service
You may edit insurance information including changing the insurance policy, payer information, and policy information.
Insurance tab
You may edit patient information from the Patient tab.
Patient tab
From the Providers tab you may change Insurance settings for the organization and/or the rendering provider.
Warning: Changing insurance settings from a claim will persist those changes on future claims.
Warning
Providers tab
Other
From the Other tab you may change the Accept Assignment value and add additional fields. Most payers require you to accept assignment as it relates to contract rates. It should be checked by default.
Additional Claims Fields
If needed, you may include additional claims fields on a case-by-case basis.
The fields include:
Is patient's condition related to
Date of current illness, injury, or pregnancy
Date patient unable to work
Hospital dates related to services
Outside Lab
Other Provider
Referring Provider NPI
Prior Authorization Number
Patient Account Number
Claim Note
Claim Notes
You can also add notes to a claim for logging or relaying important administrative information. The notes section is visible on each claim sub tab.
Claim notes
Once a note has been added, it can be viewed from multiple locations in the app by hovering over the note tooltip.
