Submit Electronic Claims

The process for sending Electronic Claims follows the same workflow in the system for all Clearinghouses.

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To Submit Electronic Claims, ensure the following:

• Must be connected to a Clearinghouse.
• Your Client’s Insurance Billing Information is set up. See Add Insurance to Client Profile for more information.
• The Client must have a Diagnosis in the Initial Assessment & Diagnostic tab. If multiple Cases exist for this Client ensure the Claim is linked to the correct Case. See Link Progress Note with Calendar Appointment for more information. 
• An Invoice is created for the Appointment/Date of Service for the claim. See Create an Invoice for more information.
• Once the invoice is added to Awaiting Submission the claim is generated. Be sure the invoice information is correct before this step.

There are three steps to Submit Electronic Claim:

1. Create an Invoice
2. Add the Invoice to Awaiting Submission - The Invoice becomes a Claim where it will be added to the Awaiting Submission queue.
   • While your Claims are Awaiting Submission, you can perform a general Claim scrub. Claims can be checked for common errors such as Date of Birth, Gender, Address, Diagnostic Code, etc. Claims with no errors can be submitted to the Clearinghouse.
3. Submit Claim to Clearinghouse All Submitted Claims are sent to the Clearinghouse at the end of each business day.

Billing: Submit Claim Video

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Add Claim to Claims Awaiting Submission

You can add the claims to awaiting submission in multiple ways. You can either add it when you are creating the invoice, add it from the client's ledger, or add multiple claims to awaiting submission using Batch Processing.

Add a Claim to Awaiting Submission from a New Invoice

1. Create and complete the invoice.
2. Click the Save dropdown, and select Add to Claims Awaiting Submission.
   
    

Add a Claim to Awaiting Submission from the Ledger

1. Locate the Invoice on the Client Ledger.
2. Click the Actions button and select Add to Claims Awaiting Submission.
   
    

Add Multiple Claims to Awaiting Submission Using Batch Processing

1. Click Billing from the Primary Navigation Bar.
2. Select Batch Invoicing from the left menu.
3. Navigate to Process Existing Invoices.
4. Select the filters you wish to find invoices to add to Awaiting Submission. Click Search
5. Select the claims you wish to add + click "Add to Awaiting Submission"
   

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Check Claims for Errors & Submit Claim

Checking for errors in the system is a simple scrub that checks for missing items such as an address, birthdate, Provider, etc. It will not validate that the information entered is correct, it is simply searching for missing information.

1. Click the Billing tab in the primary navigation bar. Claims > Awaiting Submission tab displays.
2. Select checkboxes for Claims you wish to check.
3. Click the Check Select Claims for Errors button above.
4. Fix prompted errors.
5. Select appropriate Claims and click the Submit Select Claims button.
   
    

Claims will now display in the Submitted tab and are sent to the clearinghouse daily.

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