During the course of a patient's visit, invoices are created by various staff within the office. We recommend the person responsible for submitting the claim is the only person to authorize the invoice. This allows the billing person an easy way to generate a working list of insurance invoices.
Instructions
Pending Invoices
- Access Accounting > Invoices.
- Complete a search with the following criteria:
- Location: Leave the default location or change to another location.
- Status: Active
- Approval: Pending
- Payer Type: Insurance
- Click 'Search.' Note: A list of pending insurance invoices display. See Example This list is used by the billing person to preview and adjust the claim information prior to authorizing each invoice.
Preview and Adjust Claim
If a diagnosis code needs to be added, complete the instructions for either Add Diagnosis to Every Line Item, or, Add Diagnosis to Individual Line Item.
Add Diagnosis to Every Line Item
- From the list of pending insurance invoices that display after the instructions above are completed, open an invoice.
- If the Diagnoses that display in the column are inaccurate or if a diagnosis does not display, click 'Diagnoses' in the invoice header. See Example
- In the Select a Diagnosis modal, click the + icon to add the appropriate diagnosis. Note: The diagnosis is added to the Selected Diagnoses column.
- If a diagnosis needs to be added to the invoice but it is not listed under Available Diagnoses, click the patient's name hyperlink and follow the instructions for Add Diagnosis to Patient's File.
- Continue to add available diagnoses, if needed. See Example
- Access Additional Claim Info tab to update Referring Provider, Driver's License, and Notes.
- The Notes field is limited to a maximum of 100 characters.
- To add a referring provider, access the appropriate instruction page within Claims - Canada.
- Click 'Save.'
- Click 'Authorized.' Note: The action of authorizing an insurance invoice generates a claim. See Claims instructions below.
Add Diagnosis to Individual Line Item
- From the list of pending insurance invoices that display after the instructions above are completed, open an invoice.
- If the Diagnoses that display in the column are inaccurate or if a diagnosis does not display, select the line item.
- In the Invoice Item Detail modal, click the + icon to add the appropriate diagnosis, and complete the fields appropriate (e.g., Additional Modifiers). See Example
- If a diagnosis needs to be added to the invoice but it is not listed under Available Diagnosis, click the patient's name hyperlink and follow the instructions for Add Diagnosis to Patient's File.
- Access Additional Claim Info tab to update Referring Provider, Driver's License, and Notes.
- The Notes field is limited to a maximum of 100 characters.
- To add a referring provider, access the appropriate instruction page within Claims - Canada.
- Click 'Save.'
- Click 'Authorized.' Note: The action of authorizing an insurance invoice generates a claim. See Claims instructions below.
Submit Claims
Complete the instructions for either Submit by Individual Claim or Submit by Batch.
Submit by Individual Claim
- From an opened and authorized invoice, access the Claim History tab.
- Click the submit icon
, located in the last column of the "Ready to submit" row. See Example
Submit by Batch
IMPORTANT: Do not submit more than 25 claims in one batch. Submitting more than 25 claims in a batch can result in duplicate claims.
- Access Accounting > Claims.
- The search criteria should default to the following:
- Location: Select the appropriate location.
- Submit Status: Ready to submit.
- Submit Method: Electronic
- Click 'Search.'
- In the Search Results grid, click the checkbox at the top of the column to submit all claims that are listed See Example, or, click the checkbox next to the individual claims.
- In the Actions dropdown menu, select Submit. See Example Note: The claims are submitted immediately to ClinicAid.