Claim Submission Process
After you create the fee slip you will find your claim under the Billing tab. Below we will describe what each of the sub-tabs are for.
Open - These are claims that are manually added and have no services. This is done under the patients menu option
Held - These are claims the clinic placed on hold for various reasons. For example, an attorney may want claims at end of care and instead of keeping them in pending or moving to complete they are placed in the held folder until ready to submit. The user must state why the claim is moved into held & it updates the claim log.
Submitted - These are claims that were selected from the pending folder and submitted to ChiroSpring.
In Process - These are claims submitted to ChiroSpring that have not yet been submitted to the ChiroSpring Clearinghouse. We submit claims to the ChiroSpring Clearinghouse three times per day.
Prepay Cash - These are claims that do not need to be in the pending folder as they are cash services. Prepay Cash Claim can only be changed from the claim page.
After you have created the fee slip you will find your claim(s) in the Pending Claims folder. Using the action button will allow you to submit the claim to suite your preference (e.g. paper, to ChiroSpring Clearinghouse, etc.).
After the clinic has triaged and edited the claims, they select the claim to take the appropriate action.
Send to Held Claims Folder - Use this option if you want to keep your claims on hold (e.g. not submit them at this very moment).
Submit to ChiroSpring Clearinghouse - You will need a subscription to ChiroSpring Clearinghouse to use this option. This is the recommended clearinghouse as the submission is one click and we post your ERAs for you. This makes running your practice very smooth.
Change to Complete - Claim Completely Processed and/or Not Submitted to a Payor
- This will move the claim from the Pending Claims Folder (brown claim) to the Completed Folder and it will become Green or Black. Green with Patient Responsibility or Black if $0 claim balance
Send to ChiroSpring Claim Assembly - Do Not Use
Generate CMS - This will create a PDF of your claim including the red claim lines. See below.
Submit Paper - This will generate the claim on a CMS-1500 claim form (the claim form with the red lines). Make sure your printer is loaded with blank claim forms before selecting this option.
Submit EDI - This will generate an EDI file. You can manually upload this into a clearinghouse such as Office Ally or WayStar. We recommend using our fully integrated ChiroSpring Clearinghouse instead. Submission is easier (one click to submit). In addition, when you use the ChiroSpring Clearinghouse we also post your ERAs for you (AWESOME!!!).
Complete Submission - If you submit a claim to a payor using any option other than Submit to ChiroSpring Clearinghouse, such as Print/EDI, Complete Submission will move the claim out of the pending claim folder (Brown Claim) and it will become a Red Claim.
*Red Claims are first submission claims to the clearinghouse and has not received a payor response