Overview:
In ChiroHD, the Insurance History tab features a button formerly labeled "New Bill," which has now been renamed "Create Claim." This button is designed to bypass the standard claim validation process and is intended for use by billing experts. It is important to understand the functionality and risks associated with this button to avoid misuse in your regular billing workflows.
Video Tutorial: Click Here |
Purpose of the "Create Claim" Button:
The "Create Claim" button allows users to create a claim that can intentionally bypass the main validation process but still performs important checks (e.g., for diagnosis codes and billing providers). This option is specifically intended for billing professionals who understand when and why they need to bypass validation for specialized reasons.
Who Should Use the "Create Claim" Button:
This button should only be used by billing experts such as insurance billers or billing companies. These users may have a specific reason to bypass validation temporarily. However, this should never be an office's everyday workflow when creating claims, as skipping validation could lead to billing errors that may affect claims processing.
Important Note:
Do not make the "Create Claim" button part of your regular workflow.
Always follow the regular billing process via the Insurance tab on the home screen, which ensures proper validation and fewer errors.
Key Validation Errors:
Even when using the "Create Claim" button, there are two critical validation checks that cannot be bypassed:
Missing Diagnosis Codes (DX Codes): Claims without a valid diagnosis code cannot be created.
Missing or Invalid Billing Provider: Claims must have a valid billing provider associated with the services rendered.
If these errors are present, ChiroHD will block the creation of the claim until the issues are resolved.
Process for Creating Claims Without Validation:
If you choose to use the "Create Claim" button:
Review and fix any errors flagged by the system (e.g., missing DX codes or billing providers).
Once the errors are corrected, you can proceed to create the claim.
After creating the claim through the Insurance History tab, you must manually send the claim via the Insurance > Claims History tab (either to the clearinghouse or print it as a paper claim).
This process includes additional steps compared to the regular billing workflow to ensure that only qualified billing experts use the "Create Claim" feature.
Upcoming Changes:
ChiroHD is developing version 3 (V3) of the insurance process. This update may change the look and function of the Create Claim button and the overall process. More prompts, warnings, and restrictions will be added to guide users and prevent accidental misuse.
Best Practices:
Avoid using the "Create Claim" button unless absolutely necessary.
Always use the Insurance Dashboard and follow the standard claims process for most billing tasks.
Ensure that your billing team understands the implications of bypassing validation and uses this feature only in rare, specific cases.