PERMISSIONS REQUIRED: You need the Admin permission to edit a payer. You need the Billing permission to create a claim from a billing account.
Claims can either be created automatically when charges are submitted from a daily note or manually after a daily note has been signed.
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Automatically Create Claims
For claims to be automatically created when charges are submitted, both the patient and their payer must have the option turned on.
NOTE: Billing Codes can Skip Claims. A claim will still not be created if all of the billing codes are set up to go directly to the billing account.
Turn On Automatic Claims for a Patient
- In the upper left of Fusion, use the Search Patients... field to search for and select a patient.
- In the Patient section, go to the Therapy/Medical Details section and set the Generate Claims field to "Automatically".
- Click the Save button.
Turn On Automatic Claims for a Payer
- Go to Admin → Basic Setup → Payers.
- Click the payer you want to edit.
- Click the Billing tab.
- Change the Claims field to "Generate automatically".
- Click the Save Payer button.
Manually Create a Claim
If a claim wasn't automatically created or was deleted, you can manually create the claim from the patient's billing account. Once a claim has been created, you can review it from the claim list.
- Go to Billing > Billing Accounts.
- Click the billing account for the patient you want to create a claim for.
- To the right of the visit, click the Create Claim icon
.
TIP: Not able to click the icon? You can only create a claim if the therapist has submitted charges on the daily notes and a claim does not already exist. - To confirm that you want to create the claim, click the Create Claim button.