Creating and Submitting Manual Claims

Summary

This article provides instructions for creating and submitting manual claims from the patient's Insurance Claim Queue within a patient's account, as well as from the global Insurance Claim Queue located under the Financial tab on the Cloud 9 menu bar.  Additionally, how to add the Insurance Company information on the patient under the Insurance tab.

If the insurance company information has not been added to Cloud 9, please use the links below for instructions.

Entering an Insurance Company in Cloud 9

Entering an Insurance Billing Center in Cloud 9

Please add the patient's insurance information on the Insurance tab. Kindly follow the steps below to complete the process.

Step 1. Once you are on the patient's account, select the Insurance tab

Step 2. Click '+Add.'

Step 3. The Add Patient Insurance screen enables you to input the subscriber's insurance information, which will be included in the insurance claim.

Categories on the Add Patient Insurance screen

Plan Info Tab

1. Is Active - Check mark this to make the insurance show as Active.  This will put an Insurance tab ledger.
2. Employer Plan -If the insurance provider is associated with an Employer Plan, you may search for the Employer's Plan, and the insurance information will be automatically populated under the Insurance Company field. To link an insurance provider to an Employer, please navigate to Edit > Setup > Employer.
3. Insurance Company -If the insurance company is not associated with an Employer, please click the search icon to locate the Insurance Company.
4. Subscriber - Use the drop-down arrow to select the Subscriber.
5. Responsible - Use the drop-down arrow to select the Responsible Party.
6. Fee Schedule - If you have Fee Schedules setup for insurance
7. Default - If you want to use a Default Fee Schedule
8. Policy Number - Subscribers Policy Number
9. Group Number- Subscribers Group Number
10. Accept Assignment - If the practice is going to accept payments from the insurance company check this box.  If the box is left unchecked the insurance payments will go to the subscriber
11. Initial Claim Required - Check this box if an Initial Claim is required
12. Continuation Claim Required - If this insurance requires Continuation Claims check this box
13. Policy Notes - Enter the notes regarding this insurance
14. Insurance Info - Enter the Insurance company address and Contact Information
15. Benefits Tab - Under the Benefits tab you can enter the Insurance company benefits 
16. Click Add and the Insurance company and information is setup on that patient.

How to Submit Manual Claims from Patient's Insurance Claim Queue

Step 1 - From the patient drop down arrow, select Insurance Claim Queue.

Step 2 - The Insurance Claim Queue screen will open.  Select '+Add.'

Step 3 - Use the drop-down arrows to select the Insurance Plan and Claim Type, enter the Claim Date then click Add.

Step 4 - Once you select "Add," the claim form will open, allowing you to manually enter the necessary information.

To add a claim from the Insurance Claim Queue outside of the patient's account, navigate to the Financial tab, select Insurance Claim Queue, and then follow the same steps outlined above to add the new claim.

For more information see this article: Navigating the Insurance Claim Queue.
 

As always, if you have any further questions, please do not hesitate to reach out to Cloud 9 Support by emailing us at cloud9support@planetdds.com, or chatting us online using the chat bubble on the lower right at https://cloud9support.planetdds.com/hc/en-us, or giving us a call during our business hours of 8:00 AM EST to 8:00 PM EST at the 1.800.394.6050 option 2.