Permissions: You must have Billing Permissions with the ability to "Submit Claims to Clearinghouse" enabled.
The process for sending Electronic Claims is the same no matter what Clearinghouse you use.
In order to Submit Electronic Claims, ensure the following:
- Must be connected to a Clearinghouse.
- You Client's Insurance Billing Information is setup.
- 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.
- An Invoice is created for the Appointment. You can only generate Claims from Invoices.
There are three steps to Submit Electronic Claim:
- Create the Invoice.
- Add the Invoice to Awaiting Submission - The Invoice becomes a Claim and sits in the Awaiting Submission queue.
- While you 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. If a Claim has no errors can be submitted to the Clearinghouse.
- Submit Claim to Clearinghouse - All Submitted Claims are sent to the Clearinghouse each business day at 4:30p CST.
Add Claim to Claims Awaiting Submission
- Locate Invoice on the Client Ledger.
- Click Actions button and select Add to Claims Awaiting Submission.
Check Claims for Errors & Submit Claim
Checking for errors in TheraNest is a simple scrub that checks for missing items such as address, birthdate, Provider, etc. It will not validate that information entered is correct, it is simply searching for missing information.
- Click Billing tab in primary navigation bar. Claims > Awaiting Submission tab displays.
- Select checkboxes for Claims you wish to check.
- Click Check Select Claims for Errors button above.
- Fix prompted errors.
- Select appropriate Claims and click Submit Select Claims button.
Claims will now display in the Submitted tab. All Submitted Claims are sent to the Clearinghouse each business day at 4:30p CST.