Create a Claim

Claims package up a session with the codes a payer needs to process reimbursement. Most of the data comes from the appointment and the client's insurance record; you fill in the codes and submit.

Steps

1. Open Claims and click New Claim.
2. Select the client and verify their insurance is on file. If it isn't, add it from the client's Insurance tab first.
3. Choose the date of service and link the appointment if applicable.
4. Add procedure codes (CPT):
   • Search by code or description.
   • Set units and charge for each code.
5. Add diagnosis codes (ICD-10):
   • Search by code or description.
   • Link diagnoses to the relevant procedure codes.
6. Select the payer from your list (manage payers from Insurance Payers).
7. Review everything for accuracy.
8. Click Save as Draft or Submit.

Required information

Before submitting, make sure you have:

• The client's insurance details (member ID, group, subscriber).
• Correct CPT codes for what you delivered.
• Applicable ICD-10 diagnosis codes.
• Provider NPI (configured in practice settings).

After submission

• The status moves to Submitted.
• Update it as the payer responds (accepted, denied, paid).
• Record reimbursement when it arrives.

Tips

• Save common code combinations as you work; recently used codes surface for quick reuse.
• Review denials carefully and fix the underlying issue before resubmitting.
• Keep your NPI and tax ID current in Settings → Billing.