Creating and Submitting Insurance Claims

Seamlessly create claims from both the Calendar and Clients views.

Table of Contents

Creating a new Insurance Claim from the Calendar Create Claim View Services Billing Provider Place of Service Units and Modifiers Diagnostic (DX) Code Amount Charged and Paid Insurance Plan Other Creating a Claim from the Clients View Required Information for Claim Creation Prerequisites for a ‘Ready to Submit’ claim Submitting your Claim

Creating insurance claims is easier than ever with Owl! Follow these simple steps to create insurance claims for your clients.

Creating a new Insurance Claim from the Calendar

To create a new claim, go to a session in the Calendar and select a client. Then go to Payment Actions and Create Claim.

Note: Don't see Create Claim as an option? Ensure you have completed the Create Claim requirements.

Create Claim View

The Create Claim view will pre-populate information based on based on pre-entered details from Services & Fees, Client Session, Client Coverage etc. You can make changes to your claim in this view that only impact the individual claim itself.

Learn more about each section of the Create Claim view below:

Services

The Services drop down menu allows you to modify the service provided at the session.

Billing Provider

The Billing Provider can also be modified here so that you can easily swap between provider profiles, depending on your payor enrollment status and claim submission preferences.

Place of Service

You can change the Place of Service in case this impacts claims processing.

Units and Modifiers

You can also change the number of Units and Modifiers for a service here as well.

Diagnostic (DX) Code

Diagnoses (DX) Codes from the Client Profile will automatically populate here for your convenience

Amount Charged and Paid

You can manually change the amount Charged on a session by session basis here. The amount already Paid can also be entered here.

Insurance Plan

You can select an insurance plan set up for the client here.

Other

The Other section includes information about whether or a client is In-Network, the ICN Number, as well as information on whether or not this was the original claim or whether or not the service was related to an Auto Accident.

When submitting a new claim, you must check the acknowledgement box at the bottom of the View Claim window.

Creating a Claim from the Clients View

You can also create new claims from the Clients view. This enables you to create more than one claim at once by selecting multiple services at the same time.

First, select Clients, then Insurance, and finally your client from the client list. Here you will see a list of services. By default this view will filter for claims that are Ready To Submit.

Next, you can select multiple services at once by selecting the check boxes to the left of each entry. After you have made your selections, select Create Claim to continue to the Create Claim view.

Here you will see the same view that we explored when created a claim from the Calendar view, however now there are multiple claims listed in the same view, which can be expanded by selecting the chevrons to the left.

Under the Prior Authorizations tab you can enter information pertaining to prior authorizations such the Prior Authorization Number, the CPT Code, and the dates it is Valid From and Valid Until.

Required Information for Claim Creation

Before you can successfully create and submit an electronic claim, certain fields must be completed or auto-populated by the system. If any required data is missing, incomplete, or invalid, the system will show the available action in a disabled state until you have completed the requirements.

Prerequisites for a ‘Ready to Submit’ claim

Before a claim can appear in the system (e.g., in Ready to Submit status), the following setup steps must be completed:

Billing Profile for Provider – A billing profile must be created and active for the therapist submitting the claim.
Payer Enrollment – The insurance payer must be added to the system and enrollment must be active.
Client Demographics – The client profile must include required demographic information: Address, Sex, & Diagnostic Code(s)
Client Insurance Coverage – At least one insurance coverage plan must be added to the client profile.
Attended Session – The client must have at least one attended session recorded.
Invoiced Session – The attended session must be invoiced to generate claimable charges.

Note: If any of these prerequisites are missing, a claim cannot be created and will not appear in the Ready to Submit list.

The table below outlines all fields used in claim creation, whether they are required, how they are populated, and any important notes for completion.

Field	Required	Notes
Service name/CPT code	✅	This will auto-complete for you based on the information provided when setting up the session.
Billing provider	✅	This will auto-complete for you based on the information provided when setting up the session.
Place of Service	✅	This is required for each session section.
Units/Modifiers	✅	All services must have a unit of at least 1.
Diagnostic Code	✅	At least one diagnostic code is required.
Charged	✅	An amount must be entered here.
Insurance Plan	✅	At least one coverage plan must be set up for the client and selected.
Accept Assignment	✅	This is automatically selected for you.
In-Network	✅	This is automatically selected for you.

Submitting your Claim

Once you have entered in all of the necessary information, the Submit Claim button will turn green and selecting it will submit your claim.