Generating individual electronic claims

You can generate individual claims directly from a purchase or generate batch claims from the billing module. 


Here's how to generate individual claims: 

1) Select the transaction for which you'd like to generate a claim and navigate to the Invoices tab. 

2) You can preview the claim's current status from this screen. Claims can only be generated for payor invoices in the Unsubmitted status. If the claim is in Pending status, you may need to provide additional information before it can be generated.

3) Click the gear icon to open a preview of the claim. 

 

2)  The claim information is pulled directly from the corresponding transaction. To edit any information on the claim, you must do so from the purchase, patient record, and/or clinic settings.

 

3) You can either Test or Submit this claim.

  • Clicking Test will run a check against ChiroUp business rules for claims generation to ensure the claim has the minimum required information to generate the claim. Any missing information will be shown and you will be able to resolve those errors at that time.
  • Clicking Submit will run the same checks as Test, but if the claim passes the check, it will automatically move the claim into Submitted status and download the generated claim for for the user. 

4) If you click Test, the claim will indicate any missing information. If services and diagnoses are not locked, you can lock them from this screen. For other errors, navigate away from the claim to enter the required information.

  • Enter missing patient information from the General tab of their patient record. Click the check mark next to each line item to notate it's been addressed.
  • To lock service and diagnosis pointing, you can use the icons alongside that line item. 
    • The icon on the left (🚫) will lock the services and diagnosis pointing from this screen.
    • The icon on the right (↗) will bring you to the transaction so that you can review service and diagnostic codes before locking. 

 

5) After resolving all errors, you can either re-test by clicking the Test button again, or clicking Submit to submit the claim

  • If you re-test the claim and all require information is there, the claim will move from Pending status to Unsubmitted status. 

 

6) When you're ready to submit the claim, click Submit. This will move your claim into submitted status and automatically download your generated claim form. 

 

 

 

 

 

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