Once your Claim.MD account is linked, you will be able to start managing and submitting claims from within your Practice Better Portal.
- Creating Claims for Clients
- Viewing Claims
- Resyncing Claims
- Submitting Claims
- View and Track Claims Status & Reconciliation
- Track Outstanding Client Payments - Inform & Invoice Clients of Open Balances
- Viewing ERAs + Responding to Rejections
Creating Claims for Clients
Creating claims from the client record
Claims can be created directly in your client’s record or from a scheduled session on your calendar.
To create a claim from your client’s record, go to My Clients and open your client’s record. Select Billing & Payments from the menu on the left and go to the Claims tab.
Click the Fast Action Button in the bottom right corner to create a claim. You will then see a pop-up that will list sessions that have been booked with your client. You can choose to create a claim for existing sessions, or you can create a new one.
Creating claims from your calendar
To create claims from your calendar, go to My Schedule>My Calendar. From here, click on a scheduled session and click the Create Claim button.
For more information on creating claims, check out this article.
To view your claims, go to My Practice > Insurance Claims. On this page, you will see a list of all the claims you have created for clients.
To the right of each claim, you will see one of the following terms. This indicates their status within the portal:
Draft: This indicates that the Claim has not yet been submitted.
Ready to submit: This indicates that the claim is complete and ready to be submitted.
Rejected: This indicates that there is information missing. It will need to be corrected before the claim can be re-submitted.
If you click on the claim, the information panel on the right side will show you the missing information.
Submitted: This indicates that the claim has been submitted and is currently pending.
Paid: This indicates that the claim has been approved and payment has been released.
Claims will be resynced automatically every 12 hours.
If you would like to manually resync your claims, you can open the More Options Menu (3 dots) in the top right of the claims manager and select Update Claims.
When a claim is first created, the status will be set to Draft. Once you are done adding the necessary information, switch the claim to Ready to submit.
To do this, open the More Options Menu (3 dots) to the right of the Claim and select Update Status.
Here, you can update the status to Ready to submit and leave any additional notes.
If you have multiple claims to submit at one time, you can click the Select multiple button above your claims.
This will allow you to update the status or submit multiple Claims simultaneously.
View and Track Claim Status & Reconciliation
To view your claims, go to My Practice > Insurance Claims.
You can then filter your claims based on the date issued, the practitioner, and the claim status using the options on the left-hand side.
To ensure that Claims are automatically transmitted within Claim.MD, log into your Claim.MD account, and go to Settings in the bottom left corner. Then click the Account Settings tab and ensure you have disabled, Transmit Aprroval Required.
This will ensure that valid claims are marked for transmission immediately, which will then be updated within Practice Better.
From within the Practice Better portal, this information will sync to every linked account every 12 hours. If you wish to manually pull the latest payment info and update the claims. you can go to My Practice > Insurance Claims, click the more options menu (3 dots), and click Update Claims.
This is currently limited to running once per hour.
Track Outstanding Client payments - Inform and Invoice Clients of Open Balances
For any claims that have been paid. You will see the claim amount and the amount paid next to the claim status.
If the total Claim amount has not been paid, you can contact the clients and inform them that the insurance provider did not cover the total amount of the claim. You can then choose to create an invoice to collect the remaining balance.
If you want to contact clients, you can use the secure messenger within the platform. Check out our help article for more information on using secure messaging.
If you wish to invoice the client, click the more options menu (3 dots) next to the claim and click Create/Edit invoice.
An invoice will then be automatically created for the remaining balance not covered by insurance.You can then send this to the client for payment or process the card on file immediately.
For more information on invoices and processing invoices, click here.
Viewing ERAs + Responding to Rejections
You can view the ERA status and history within Practice Better after your claims have been paid.
To view this information, go to My Practice > Insurance Claims, and click View next to your paid Claim.
On the right-hand side, you will then see the ERA status and the history further below:
When claims are rejected, you will see this reflected in the status next to the Insurance Claim.
To view the reason for the rejection, click more options menu (3 dots) next to your Claim
Then, on the right-hand side, you will see the message history, which will state the reason(s) for the rejection.
To make the necessary changes, you can click Edit next to the Claim.
The claim will then open in a floating window where you can make the necessary adjustments to resubmit the claim.
You may also need to make changes to your insurance billing information.
To learn more about how to adjust these settings, click here.