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Creating a Patient Claim (US)

 To create a patient claim, you can begin from two main areas; The Patient’s Profile or from their Appointment.

From the Patient Profile

  • Search for your patient under the Patient tab.

  • Go into their Billing > Claims and click New Claim

From the Appointment:

  • Click on the Appointment on the Schedule

  • On the Appointment pane, scroll down to the Insurance Info area

  • Click on “Add” button under Primary Policy or the “Add Claim” button at the bottom on the Insurance section.

Regardless of which way you start, the process from here is the same.

  • Give the claim a name – this is internal and should be useful in identifying the claim.

If you are selecting a Health Insurance insurer (to generate a CMS1500), you will want to ensure you fill out as many of the fields as possible, including the Claim, Employee or ID number, the Policy, Group, or Plan number, and the Insurance Plan Name so that these populate in fields 1A, 11, and 11c of the Health Insurance Claim Form.

While you can always return to this later to fill in more details, you will want to complete this before you generate a CMS 1500 form or submit a claim.

  • Then click Save and you’re all set. The claim will now show up under the patient’s Claims area.

  • Or on the Appointment pane

The next step is Adding Billing Codes and Insuring a Patient Visit.