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Step 1: Create Claim

  1. Create Claim:
  2. Navigate to the claim creation section.
  3. Enter SOC (Start of Care) Dates: Specify the “From” and “To” dates for the SOC period.
 

2. Claim Type Selection:

  • Choose the type of claim you are processing (NOA Claim or Medicare Claim).
 

3. Validation:

  • NOA Claim/Medicare Claim – Validate:
  • Errors: Must be corrected before proceeding. Errors typically block the claim from moving forward.
  • Warnings: May not prevent submission but should be reviewed and addressed as needed.
 

4. Generate NOA Claim:

  • Click “Generate NOA Claim” to create the claim once validated.

5. Resolve Issues:

  • Address any validation errors or warnings as indicated.
  • If resolved, proceed to Step 2.
 

6. Submit to DDE:

  • For Medicare claims, ensure submission to the Direct Data Entry (DDE) system if required.
 

7. Mark as Submitted:

  • After submission, update the claim status to “Submitted.”
 

8. Export Data:

  • For documentation or record-keeping, export the claim data as needed: Download as PDF or Excel.

Step 2: Batch Claim

  1. Active Payer/Insurance:
 
  • Ensure that the payer or insurance is active and correctly configured for batch processing.
 

Batch Claim:

  • Process claims in batches if applicable.
  • Handling Incorrect Claims: Click Delete Claim if a claim or part of the batch is incorrect.
  •  Use the Pen and Paper Icon to edit and correct any issues with the claims.
 

Printing:

  • Click the red PDF icon to print the batch claim if needed.

Step 3: Submit Claim

 

Unbatch Claim:

    • Prepare the claim for submission by un-batching it if necessary.
 

Submit Claim:

Choose your submission method:

  • Manual Submit: Submit the claim manually if required.
  • Electronically Submit: Use the electronic submission option if available.
 

Export Data:

  • Export the claim submission data in the desired format: CSV or Excel.

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