📝 Overview
The Create Claims screen is your central workspace for building and submitting insurance claims. When you open it, ChiroHD automatically pulls all charges that are pending insurance billing — claims on patient ledgers with an unbilled status. The screen validates those claims as they load, helping you catch issues before a claim is ever created.
Accessing the Create Claims Screen
Navigate to your Live Location, Insurance Tab, Create Claims.
NOTE: When you open the create claims screen, ChiroHD automatically pulls any charges that are pending insurance billing. These are services that appear in the patient's ledger within unbilled status and are ready for claim creation.
Understanding the Filters
Before working the claim queue, it's worth understanding how the filters shape what you see.
Claim Type — Controls which services appear in the queue based on how your payers are configured. Options include:
Standard Electronic
Single-Day Electronic
Standard Paper
Single-Day Paper
Select payer(s) from list
Select patient from list
This filter doesn't limit how you submit a claim — it reflects how your payers are set up and which queue they will appear in.
For example, many offices configure personal injury or attorney payers as paper-billed so those claims appear in a separate queue, out of the way of standard electronic claims. You can still create an electronic claim for any payer regardless of this setting.
This claim type is set up by Payer. If you have further questions on the Payers settings, please see our other resources.
Responsible Payer — Switch between Primary and Secondary claim creation. This is one of the most important filters to verify before you start working claims.
Date Range — Defaults to the past 12 months. Use the quick date buttons (This Year, Last Year, Last 12 Months) or set a custom range. If expected claims aren't appearing, check the date range first.
Include Billed to Secondary — When working on Primary claims, an additional checkbox appears: Include Billed to [Payer]. This controls whether claims that have already been billed to the secondary insurance appear in the queue. By default, they're hidden. Enabling the checkbox is useful when researching claim history or performing rebills. The checkbox label adjusts automatically depending on which payer level you're viewing.
Payer / Patient — Filter down to a specific payer or patient when you need to focus on a particular account or work a targeted batch.
Troubleshooting Tip: If claims aren't showing up in the queue, check the Date Range and Responsible Payer filters first — those are the most common causes of missing items.
Failed Validation Tab (Green Sheets)
As claims load into the queue, ChiroHD runs automatic validation checks on each one.
Items in Failed Validation are sometimes referred to as Green Sheets.
What are Green Sheets or Failed Validation?
Green Sheets are claims blocked from billing until the issues are resolved — leaving them unaddressed puts you at risk of missing timely filing deadlines.
Where do I see Failed Validation/Green Sheets?
Green Sheets or Failed Validation can be seen two places:
In the Create Claim Tab, Failed Validation Tab.
On your home screen, there is a Green Sheet Icon which is helpful for office staff handling corrections outside of the billing workflow.
Common Failed Validation/Green Sheet issues include:
Missing or incomplete insurance coverage information
Missing diagnosis codes
Missing or non-finalized SOAP note
Missing patient demographics (name, date of birth, address, sex)
Missing billing provider NPI
Resolve Failed Validation items before creating claims. Any service held in failed validation cannot be billed out.
If you have further questions on this subject of Greensheets, please see our other resources on these Failed Validation/Greensheet Errors.
Reviewing Claim Details
Once validation issues are addressed, switch to the Claim Details tab to review what will be included in the claim.
The claim summary shows:
Total amount to be billed
Patients included in this claim
From / To — the service date range
Posting Date — required before you can create the claim
Memo — optional, for internal notes
Resubmission Code and Original Reference Number — only needed when rebuilding a corrected or resubmitted claim
Click on any patient in the list to expand it and see the individual service lines, CPT codes, modifiers, diagnosis codes, and billed amounts that will appear on the claim.
Use the Quick Filter field to search the patient list by name when working a large batch.
By default, all patients are selected. You can uncheck individual patients if you only want to create a claim for a specific subset — for example, when adding a resubmission code that applies to one patient only.
Creating the Claim
When you're ready, click Create Claim.
Once the claim is created, ChiroHD displays the message: "Your claim has been successfully created, what do you want to do next?" At that point, you'll see the following options:
Send to Clearinghouse — Only appears if your office has a clearinghouse SFTP integration configured.
Sends the electronic claim file directly from ChiroHD to your clearinghouse account. No manual download or upload needed. Supported clearinghouses for direct SFTP submission are Office Ally, Trizetto, and Availity.
Once sent, the button updates to show the date and time it was transmitted and becomes disabled to prevent duplicate submissions.
Download Claim Document — Creates the electronic claim file and saves it to your computer. You then upload it manually into your clearinghouse portal. This is the typical option for offices without a direct SFTP integration.
Preview on HCFA — Displays the claim on a CMS-1500 form without printing or submitting it. This is one of the most useful quality-control steps available — use it to verify all information is correct before transmitting.
Print to HCFA — Formats the claim for printing onto a physical CMS-1500 form. Clicking this button opens a dropdown where you can choose Standard or any custom printer configuration your office has set up.
Create another claim — Returns you to the claim queue to start a new claim without leaving the screen.
Delete claim — Removes the claim from the billing workflow so it can be rebuilt after corrections. Use this only when a claim was created incorrectly and genuinely needs to be recreated — verify before deleting.
Secondary Billing Considerations
Creating a secondary claim requires completing these steps in order:
Create and submit the primary claim.
Post the primary EOB.
Verify that adjustment information is present on the EOB.
Create the secondary claim.
Claims will only appear in the secondary claim queue after the primary claim has been created and the primary EOB has been posted.
Adjustment information is critical for secondary billing. When the secondary payer adjudicates the claim, they need the full picture of what the primary payer paid and adjusted — contractual adjustments, coinsurance, copay, and other write-offs. Without this, secondary claims will typically reject.
With ERA: adjustment values are auto-filled from the ERA file.
With manual EOB posting: staff must enter adjustment information manually on the EOB posting screen. If this step is skipped, the secondary claim will likely be rejected.
For more detail, see the Reason Code Behaviors article.
Key Takeaways
Resolve Failed Validation items before creating claims — blocked claims can't be billed and risk timely filing.
Use Preview on HCFA before transmitting to catch errors early.
Verify the Responsible Payer filter before creating claims, especially when switching between primary and secondary workflows.
Confirm adjustment information is entered when manually posting EOBs for patients with secondary insurance.
Use Claim Type and Payer filters to work claims in focused batches.
📌 Conclusion
The ChiroHD insurance claims screen is designed to help your office create, review, and submit insurance claims efficiently. By leveraging filtering options, validation workflows, and detailed claim review, your team can reduce rejections, increase billing success, and improve overall claim management processes.