TL;DR, submitting claims is easy to do in Sessions Health by generating a 1500 claim form and then sticking it in the mail.
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.
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.
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.
Now just confirm if you want the form with the standard 1500 form template or not.
From here, you can download the generated pdf and save it to your computer or print it directly from the web browser.
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.
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.