Many new users of Therabill ask, “I just created a trial account, what’s the bare minimum I need to do to set up my account and bill a session to insurance?“ While there’s plenty to learn and plenty of options you have in setting up the account, here’s the Bare Essentials, or just what you need to have entered to get a single claim billed to insurance.
The basic process will be as follows:
- Ensure Your Billing Information is Correct and Add Any Additional Office Locations
- Enter Your Provider Information
- Enter Your Client Information, Demographics and Insurance Card
- Create a Session on Your Calendar
- Confirm The Appointment
- Send The Claim to Insurance
So lets look at each step individually, and see how to get started!
Step 1 - Ensure Your Billing Information Is Correct and Add Any Additional Office Locations
This is the information you entered when you first set up your Therabill account. These details will populate Box 33 of your CMS 1500 claim forms, so it will be what the insurance company sees as the Billing Provider, and will be where they send your claim checks and EOB’s.
You can edit your information by clicking the Green Edit button. If you perform your services at multiple facilities, you can enter these facilities down below, by clicking the green Add Facility Button.
Step 2 - Enter Your Provider Information
Click on the Grey Add Provider Button to add a Provider to the list. The most important fields to complete here are: NPI, Taxonomy Code, First Name and Last Name. These are the only details that will go out on your insurance claims as Rendering Provider information in Box 24J of your CMS-1500 claim forms. Be sure to click Save and Done when you have completed these fields.
Step 3 - Enter Your Client Information: Demographics, Diagnosis and Insurance Card
Once you have established who the provider is, you can begin to enter in your client information. Click the Add New Client button to create a new client.
The most important fields to fill in for the purposes of insurance billing are:
- All demographic information in the top box.
- The correct Diagnosis Codes (click the Blue Pencil within the Diagnosis Cases Box to enter your codes)
- The insurance card information. (click the green Add Card button to add insurance card information)
Important notes when entering diagnosis codes:
- Until October of 2015 only ICD-9 Diagnosis codes are required for insurance billing.
- After October 2015, use of ICD-10 codes will be required.
Important notes when entering insurance card info:
- Be sure to add all necessary Demographic information.
- When entering an insurance company name, be sure to select the payer from the drop down menu. Do not enter the whole name in manually! This will cause Therabill to think that you are entering an unknown "Print Only" payer.
- Select the correct “responsibility”. (i.e. is this Primary Insurance, Secondary, etc..)
Step 4 - Create a Session on your Calendar
Find your desired time slot on the calendar, and click on it to bring up the Quick Add Session form. Select the client and provider names, then click Add More Detail.
This will bring up the Edit Session Form.
The Edit Session form is where you will enter all of the session specific details. The most important fields to complete are:
- All Scheduling Details
- Initially Bill To: Insurance
- Select the correct place code
- Enter the service CPT code
- Enter the number of units and the charge for the session.
Once complete, click Save and Done.
Step 5 - Confirm The Appointment
Click on the Green Check Mark icon to confirm that your appointment actually took place. If you are entering a DOS that is in the past, this step may have been auto checked when you were entering the appointment.
Step 6 - Send The Claim to Insurance
Click Select Client and find the client you wish to bill out for, then click on their name from the drop down menu that appears.
Click the Check Mark box next to the date of service, and press the green Create Invoice button.
Preview the claim if you wish by clicking the Preview Claim button under Double Check.
Submit the claim electronically by Clicking on the Lightning Bolt icon.
This will send your claim electronically to the correct insurance payer. Congratulations! You have now billed your first claim electronically.