To create a patient claim, you can begin from two main areas; The Patient’s Profile or from their Appointment.
From the Patient Profile
Search for your patient under the Patient tab.
Go into their Billing > Claims and click New Claim
From the Appointment:
Click on the Appointment on the Schedule
On the Appointment pane, scroll down to the Insurance Info area
Click on “Add Claim/ Policy” and then “Add New Claim/ Policy”
Regardless of which way you start, the process from here is the same.
- Choose an insurer. If you need to create a new insurer see Creating an Insurer
- Give the claim a name – this is internal and should be useful in identifying the claim.
If you are selecting a US insurer (to generate a CMS1500), you will want to ensure you fill out as much of the fields as possible, including the Claim, Employee or ID number, the Policy, Group, or Plan number, and the Insurance Plan Name so that these populate in fields 1A, 11, and 11c of the Health Insurance Claim Form.
While you can always return to this later to fill in more details, you will want to complete this before you generate a CMS 1500 form or submit a claim.
- Then click Save and you’re all set. The claim will now show up under the patient’s Claims area.
- Or on the Appointment pane
The next step is Adding Billing Codes and Insuring a Patient Visit.