Insurance Billing Process

Following are the key steps in processing and billing claims:

1. Find claims that have not been billed or that require attention.

   The status of such claims is On Hold, Timed Out, Underpaid, Overpaid, or Rejected. See Searching for Claims.

2. Review and, if necessary, edit claims. See Reviewing and Editing Claims.
3. Preview CMS 1500 forms if necessary. See Previewing CMS 1500 Forms.
4. Set the status of claims to Ready to Bill. See Setting Claim Status to Ready to Bill.
5. Bill claims to insurance carriers by using one of the following methods:
   • Bill VSP claims (or claims from a supported carrier) automatically. See Billing Claims Automatically.
   • Bill individual claims manually. See Manually Sending Individual Claims to Carriers.
   • Bill claims manually in batches. See Manually Sending Claims to Carriers in Batches.
   • Bill safety claims. See Billing Safety Claims.
   • Bill claims through TriZetto. See Billing Claims through TriZetto.
6. If an insurance carrier rejects a claim, perform one of the following actions:
   • Review and resend the claim to the insurance carrier.
   • Bill the claim to the patient. See Billing Patients.
   • Write off the claim. See Writing Off Claims.

Related Topics

• Processing Claims
• AcuityLogic Billing