Sending out claims can be an essential part of the day-to-day operations of your practice, which is why we want to make this as streamlined as possible! We’re going to break this down into a few sections for you…
First, let’s start with a simple checklist to make sure you are set up for success! 📋
Do you have the following set up?
Add ICD-10 Codes by going to Settings > Insurance Settings > ICD10 Codes
Add CPT Codes by going to Settings > Insurance Settings > CPT Codes
Add your Tax ID by going to Settings > Insurance Settings > Tax IDs
Add your Tax ID to your Clinic Information by going to Settings > Location Settings > Clinics
Add the Group NPI Number (if applicable) under Settings > Location Settings > Clinics.
Add the Provider's NPI Number to their User Profile under Settings > User Settings > Users.
Add in key Service Charges by going to Settings > Product, Invoice and Payment Settings > Products and Services
Note: You can add CPT codes to Services such as Adjustments or New Patient Fees. While you CAN add more than one CPT Code, we recommend having a max of one added for optimal mapping! CPT Codes are not required here, however, they do assist with streamlining the claim creation process, as well as assist with streamlining the creation of Invoices to send to HSAs, and HRAs.
Make sure that the Patient has the following information entered in their Patient Profile by going to Patients > Patient Profile > Details:
Full Name
Sex/Gender
Date of Birth
Address
Phone Number
Insurance Company
Patient or Authorized Signature on File
Claim Additional Information (Box 19 on the HCFA Form)
Awesome! Now that we’ve completed that quick list, let’s get those Claims created!
Claims are created from the invoices that are made from checking a patient out after their Appointment. For this reason, invoices must be associated with the patient’s Appointment.
✨PSST!✨ You can CLICK HERE for a refresh on creating an Invoice if you need to 😉
At checkout, you should see either the One-Click Claim or Queue for Claim button. Selecting One-Click Claim will allow you to send a claim directly to the clearinghouse, whereas Queue for Claim will allow you to manually walkthrough the claim before saving and/or submitting the claim.
✨PSST!✨ You can CLICK HERE to learn more about One-Click Claim vs. Queue for Claim.
After you create a claim you can manage them from the Claims tab at the top of Clerk:
