Submit Electronic Claims

Due to the Change Healthcare Incident, TherapyNotes is in the process of switching clearinghouses. This means some of this information may not be currently relevant. This page will be updated once the switch is made. For more information, please review our Change Healthcare Incident Status Update.

TherapyNotes electronic data interchange (EDI) allows you to submit both in-network and out-of-network claims electronically through our clearinghouse.

By submitting your claims electronically through TherapyNotes, you can track claims from initial submission through posting the payments, all in one place. There's no need to log in to a third-party system and no need to worry about data entry errors.

Role Required: Practice Biller or Biller for Assigned Patients Only

Enable Electronic Claims

Note: Practice Billers, Practice Administrators, and Clinical Administrators can complete this step.

Click the User Icon > Settings > Practice Billing (in Billing section)
Select the Enable Billing Features checkbox
Select the Enable Electronic Claims and ERA checkbox

For more information about setting up your account for billing in TherapyNotes, read Quick Start: Billing.

Locate Claims Ready to Be Submitted Electronically

Follow one of the methods below. Claims are ready to be submitted when a clinician completed and signed a billable note for a client who is set up to bill their insurance. The bubble next to Submit Electronic Claims throughout TherapyNotes (such as on the main Billing page and on your To-Do list) will display the number of claims that are ready to be submitted electronically.

To view claims that are ready to be submitted: Click To-Do > Submit Electronic claims OR click Billing > Submit Electronic Claims
To view claims that are ready to be submitted for a specific client: Click Patients > Patient Name > Billing tab > Submit Electronic Claims
To view claims that are ready to be submitted for a specific payer: Click Payers > Payer Name > Billing tab > Submit Electronic Claims

On the Submit Electronic Claims page, use the Status, Payer, Clinician, Patient, and Appointments filters to find the specific claims you are ready to bill.

The Submit Electronic Claims page defaults to show you pending claims for appointments within the last 90 days. If there are pending items older than 90 days, a message will display to let you know how many other appointments are ready to bill. TherapyNotes will also show how many appointments require a note to be completed and signed before the corresponding claims can be submitted.

Submit Claims on the Submit Electronic Claims Page

1) Select the appointments you want to create electronic claims for. Each box surrounding a group of appointments represents a single claim. This is know as "batching"

(A) Select All Items Ready for Initial Submission: Click this link to select each appointment that has not been previously submitted.

(B) Checkboxes: Select the checkbox next to each appointment you're ready to submit claims for if you only wish to submit claims for specific appointments.

(C) Select All: Click this link to select all dates of service for a client and submit multiple dates of service in a single claim.

Tip: TherapyNotes will automatically group appointments on a single claim if you meet the payer's criteria for batching. Batched claims may save you money. However, if any date of service in the batch is rejected, the entire claim will be rejected.

2) Click the Review Claim Details link and verify that all information on your claim is accurate.

3) Choose whether to include only the primary diagnosis code or up to four diagnosis codes from the dropdown at the bottom of the page.

4) Click the Submit Claims button.

Tip: If your claim indicates that the client has secondary insurance, TherapyNotes includes this information on the primary claim. We ask the primary payer to forward the claim to the secondary payer when they have finished processing it. For more information, read Secondary Insurance.

Warnings on the Submit Electronic Claims page

Occasionally, you may see red or yellow warnings on the Submit Electronic Claims page.

A red warning indicates there is an error with the information on the claim that needs to be fixed before the claim can be submitted. To correct these errors, click on the hyperlinked appointment information to edit the corresponding data, or, when applicable, click on the hyperlinked text in the warning to be taken to the appropriate page in TherapyNotes to make your corrections.

A yellow warning appears to indicate potential discrepancies in claim information or other non-crucial concerns. For instance, this may appear when you are billing as a supervisor but one claim is billing as the rendering clinician, or when a client has hospitalization dates inputted. You can still submit a claim with the yellow error if the information is correct.

Next Steps

Once a claim has been created, track its status with Electronic Claim History
If a claim is rejected, read Resubmit Electronic Claims
If a claim is paid, see how much you were paid with What Is Electronic Remittance Advice