Are you working with an external biller or a dedicated billing staff and you’d like a way to communicate when a claim is ready for submission? Would you like to review your claims (i.e. to make sure you’ve added in all required codes) to make sure they are ready for submission?
If so, keep reading!
New Claim Submission Work Flow: Unsubmitted
By default, when you arrive an insured visit in Jane (which generates an invoice for both the client and payer), the insurer invoice is categorized in an Unsubmitted state.
All of your Unsubmitted claims are housed within your Unsubmitted Claims Folder that can be found in your Billing tab.
If this work flow works for your then great! No need to change anything. :)
New Claim Submission Work Flow: Draft > Unsubmitted
If you would like to review your claims before they end up in your Unsubmitted folder, then you can change your account default so that when insured visits are arrived, they start in a Draft state instead of Unsubmitted.
Having your claims start off in a Draft state is helpful if you are working with external billing staff and you’d like to ensure that all claims they submit have first been reviewed. Your biller can then work out of the Unsubmitted folder and only submit claims once marked as Unsubmitted.
When you have reviewed your claim and deemed that it’s ready for submission, you’ll need to change its state from Draft to Unsubmitted. There are a few different places where you can mark a claim in Draft form as Unsubmitted, one of which is from the Appointment panel when working from the Schedule. From here, you’ll just need to press the dropdown arrow beside your claim and select the Mark as Unsubmitted option.
You can also head to the main Billing tab at the end of the day and there is a Draft folder that you can review and select to mark as “Unsubmitted”.
Note to our US Customers: Claims that are in Draft form will need to be marked as Unsubmitted before you can generate an EDI for submission.
Changing Your New Claim Submission Default
To change your new claim submission default, you’ll need to head to Settings > Billing Settings. From here, you’ll be able to choose if you’d like your insurance claims to begin in a Draft or Unsubmitted state.