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Creating a Patient Claim

 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.

  • Give the claim a name – this is internal and should be useful in identifying the claim.

  • The only mandatory information is the Claim Number.  For insurers who don’t use claim numbers, you can use the patient PHN or another identifier.

  • Enter any other information you’d like to record or track on the claim.  You can always return to this later to fill in more details.

  • You can enter default billing codes here, if appropriate. For claims where you bill more than one item or area of treatment, you can see under all the codes you’ve added “Add Additional Billing Codes.” This allows you to add on as many billing items as you’re needing. And you can also “Add Diagnosis” and “Add Modifier.”

  • All of these will automatically load to an appointment when you add this as the first 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

Further Reading:

Booking an Insured Visit

Submitting Invoices by Paper

Submitting Invoices through a Portal

Receiving an Insurer Payment

Hope this helps!