How to submit claims to insurance companies

TL;DR, submitting claims is easy to do in Sessions Health by generating a 1500 claim form and then sticking it in the mail.

Enter an insurance policy for clients

Before submitting a claim, you’ll want to make certain you have a policy on record for each client who you want to submit claims for. To state the obvious, before meeting with a client, get a copy of the front and back of their insurance card. The phone number on the back of the card for providers is the one you want to call. To find out the benefits for a client, you’ll also need the patient’s date of birth. If you’re in-network with the provider, you’ll typically need your organization’s NPI number as well. Many insurance companies have automated systems for obtaining patient benefits. However, some don’t and in those cases, you’ll speak with someone directly.

Generate a 1500 claim

The standard format for submitting a claim to insurance companies is called a 1500 form. What’s a 1500 form, you ask?

The Form CMS-1500 is the basic form prescribed by CMS for the 
Medicare and Medicaid programs for claims from physicians and 
suppliers. With the transition of the medical community 
to electronic data interchange and the proliferation of data 
element definitions among various payers, it became essential 
that an organization be established to maintain uniformity and 
standardization in these areas. The NUCC (National Uniform 
Claim Committee) is responsible for maintaining the integrity 
of the data sets and physical layout of the hard copy 
1500 Claim Form.

From a client bill screen in Sessions Health, you can generate a 1500 claim from the bottom of the screen.

Sessions Health generates your 1500 form for you

This will take you to a wizard that will walk you through creating the 1500 form. You’ll select the correct policy for the patient and verify the information and services.

Verify the 1500 form data

Now just confirm if you want the form with the standard 1500 form template or not.

Download your 1500 form

From here, you can download the generated pdf and save it to your computer or print it directly from the web browser.

Mail your 1500 claim

The final step is to put the claim in an envelope and mail it to the claims address. You’ll find this address on the back of the patient’s insurance card. There’s generally no need to mail the claims by certified mail or anything other than just first-class mail using a stamped envelope. Depending upon the provider, you can check the status of a claim by visiting the provider portal or calling the same number for providers listed on the back of the patient’s card.

Conclusion

That’s a wrap for how to submit your claims to insurance companies. If you follow the steps above, you can easily generate 1500 forms for your patients each month and get them in the mail. While the turnaround time will vary by insurance provider, you should get paid for claims typically the month after you submit them.