How to Create an Electronic Claim

When you submit a claim, you have two options: Print & Mail or Electronic (EDI). Before you can create an electronic claim, the client must have an insurance card that is mapped to an electronic payer ID. For more information, please see: Insurance Card Mapping.

Create an Electronic Claim

1. Navigate to Billing > Bill Insurance.
2. Use Select Client to display a client's billable services. You can use the filters to narrow your results. If a client or session is not listed, please see: Missing Session.
3. On the invoicing screen, use the checkboxes to select which lines you wish to create a claim for. 
4. Click Create Invoice.
5. In Additional Settings, you have the option to check One Date of Service per claim. Some insurances require this.                              
6. On the Create Invoice window, select the lightning bolt icon on the insurance card you wish to bill. 
7. The claim will be created once the claim has passed the error check.

I want the payment to go to a P.O. Box.

For more information on P.O. Boxes, please see: Use P.O. Box for Insurance Payments.

Do I need to save a paper copy of the CMS-1500?

Whether or not you want to save a paper copy of the CMS-1500 for your records is up to your preferences and clinic policies. The application will store a digital copy of the CMS-1500 under Filing > CMS-1500. Additionally, the application also retains a copy of the EDI (837) file that was created. You can view the EDI file by clicking the  icon and selecting View EDI file.

For more information on EDI files, please see: How to Read an EDI (837) File.

Note: The EDI file will always contain more information than can be listed on a CMS-1500. There are not corresponding boxes on a claim form for all of the information that is included in an EDI file.

Do I receive status updates on electronic claims within the system?

All claims that you submit electronically will have electronic status updates delivered to you. For more information, please see: Tracking Insurance Claims.