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.

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 Prior Authorization Number, referral information, 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.

Note: Missing Information

If any information is missing, cannot be populated, or there is an issue blocking the claim submission, an error message will appear here to notify you which information is missing and must be entered before continuing.

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.
Paid	❌	If a payment has been made for the Session(s) selected for a claim, it will appear 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.
Referring Provider	❌	All of the referring provider information must either be blank or if there is a referring provider all of the accompanying information must be populated.
Prior Authorization Number	❌	Auto-populates if there is a Prior Authorization Number on Client Profile.
Referring Provider Name	❌	All of the referring provider information must either be blank or if there is a referring provider all of the accompanying information must be populated.
Referring Provider NPI	❌	All of the referring provider information must either be blank or if there is a referring provider all of the accompanying information must be populated.
Referring Provider Taxonomy	❌	All of the referring provider information must either be blank or if there is a referring provider all of the accompanying information must be populated.
ICN Number	❌
Submission Code	✅	A Submission Code of 1 is auto-populated for all new and original claims
Auto Accident	✅	Yes or no must be selected.
Acknowledgement Check box	✅	This must be checked to proceed.

 

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.