How to Bill Claims
Charges that have been posted sit in the Charges F3 tab under Posted CMS or Posted UB and are ready to be turned into claims. To create and preview a claim, follow the instructions under Post Charges and Create Claims. Once a claim has been created, it moves to the Claims F4 tab. If there is a payer associated, the claim moves to Billable status, if there is no payer it moves to At Patient.
- Log in to INSIGHT Billing, select the Claims F4 tab.
- Select the Billable category.
- Select the claim(s) to bill and click Bill. Use Select All to select all claims, the Ctrl key to select specific claims, or the Shift key and click and drag to select a group of claims.
- The Create Bills window, shown below, will display. This indicates how many CMS-1500 claims will be printed or sent electronically and the number of UB-04 claims that will be printed or sent electronically.
- To submit claims electronically, select the Process EDI radio button in the CMS 1500 or UB-04 Electronic Files to be Created section.
- To print claims, select the appropriate printer and paper tray from the drop-down menus under the New 1500 Claims to be Printed On or UB-04 Claims to be Printed On sections and check the box next to Process.
- Before printing, make sure to assign printer and tray settings and check the Process box in the Chart Note and EOB sections in order to print chart notes or EOBs for the selected claims. View Print Chart Notes with Claims for a more detailed explanation of how to print chart notes.
- Optional: Click any Preview button to a copy of the EDI file or printed claim.
- Click OK to close the Create Bills window and return to the Claims F4 tab. The claim is now moved to the At Payer category.
Note: Only claims that have been selected to process are created. If the Process check box is not selected, the claim stays in Billable. If paper claims are being submitted, a confirmation prompt displays to check if paper forms have been loaded and if the claims printed properly. Once you acknowledge the claims printed properly, the Print Process box displays for you to print the chart notes associated with the claim.
- A validation occurs to check things like payer authorization, if required, missing referring doctor NPI number, missing therapist NPI number, etc. If there are any validation issues with a claim, it is moved back to the Not Ready category. Refer to Troubleshoot Not Ready Claims for more information.