There may come times when you need to submit a claim by paper. Therabill can create the paper claim for you. It is very important to realize that when creating a paper claim, you (the clinic) are responsible for printing out and mailing in the claim form to the insurance company. Therabill does not print and mail your paper submissions for you.
How to Create a Paper Claim
For the sake of brevity, we will assume that you know how to create an electronic claim. If you do not know how to create a claim, we suggest that you watch our Getting Started instructional video. The getting started instructional video can be found by clicking the Getting Started Billing Insurance link at the top right of your dashboard when you log in to Therabill. There are also some instructional webinars that you might find useful, these can be found by clicking the Recorded Webinars link at the top left of your dashboard when you are logged into Therabill.
When you create a claim, there is a point where Therabill displays the clients insurance cards and you are to choose which insurance card to submit to. The image to the right shows the dialog where you choose the insurance card. Each insurance card has a set of icons associated with it. The icons from left to right are as follows.
- Blue Pencil icon: Clicking the blue pencil icon will open up the edit client form for the client.
- Magnifying glass icon: Clicking the magnifying glass icon will create a Preview of the CMS-1500.
- Adobe PDF icon: Clicking the Adobe PDF icon will create a paper claim (print & mail).
- Lightning bolt icon: Clicking the lightning bolt icon will create an EDI (electronic data interchange) claim (an electronic claim submission). This option is only available if, when creating the client's insurance card, you chose an insurance company with a Payer ID.
To create a paper claim, click the Adobe PDF icon (circled in red in the image to the right). Therabill will then create a PDF of the CMS-1500 for you and give you your display options for printing. IMPORTANT: You are responsible for printing the claim form and mailing it to the insurance company (or payer). Therabill does not print and mail the claims for you.
What version should I print?
After Therabill creates your paper claim, it will display a list of options for printing (see image to the right). At the time of this writing, the new 02/12 version of the CMS-1500 was recently released and Therabill is still offering both versions. This is why you will see 8 PDF icons to choose from. Eventually, once the 08/05 version of the CMS-1500 is no longer needed, Therabill will go back to offering only 4 versions. Below is a summary of the options.
Row 1 - New 02/12
The first row of PDF icons will print the new 02/12 version of the CMS-1500. This is required for most payers at the time of this writing. Therefore, you should probably be choosing from one of the options within the first row. Only if you know the payer is still requesting the 08/05 version should you choose from the second row.
Quick Open / Flattened versus PDF Form / Large File
The flattened files are much quicker to open (as they are smaller files). This is normally what you will be choosing from.
The PDF Form is a form file. It is a larger file, therefore, it may take longer to open. However, the form file will allow you to change information within it. That is, you can click on a field within the CMS-1500 and change information prior to printing. IMPORTANT: Be very careful with changing information on the form. Changes that you make are not saved anywhere, they can only be seen when you print it out.
Red Line versus No Line
The red line option will create a PDF with the red background. For this, all you need is a printer with red ink. Be very careful, some payers do not allow you to submit claims that are not on official CMS-1500 paper. If you submit using the red line option and you receive denials stating that they do not accept copies of the CMS-1500, then you may need to purchase CMS-1500 claim form paper and submit after printing the No Line version to the CMS-1500 paper.
The no line option will create a PDF with no background. Some insurance companies will allow you to submit claims to them with no background (make sure you know if the insurance company you are submitting to allows this). You can also print this no-line option to CMS-1500 paper.
When printing to CMS-1500 paper, if the claim does not line up: When initially printing the no line to CMS-1500 paper, you may need to adjust your settings on your printer dialog (the box that opens up on your computer whenever you print something) to get it to line up. Therabill creates the CMS-1500 PDF exactly to standard dimensions, therefore, you do not want your printer to introduce any margins (vertical or horizontal shifting) are perform any scaling (increasing or decreasing the size). If it is, then your printer is changing the dimensions and it will not line up correctly. The most common culprit is the Fit to Page option that most print drivers offer. Fit to page will change the dimensions, and usually will cause the claim to not line up to the CMS-1500 paper.
Once you click on one of the PDF icons, Therabill will open up the CMS-1500 PDF for you. How it opens will depend on your browser. Some browsers will give you a "save to your computer" option while other browsers have a download / open icon at the top or bottom of the browser window. Make sure you know how your browser downloads files, as after you create the CMS-1500 PDF by clicking on the PDF icon, the download of the PDF should start. You should then print out the CMS-1500 and put it in the mail.
Does Therabill mail in the paper claim for me?
No, Therabill does not offer the option to print or mail in the claim form for you. You should click on one of the print options (see What version should I print? above), print the claim, and then mail it in.
Do I need to save and file a paper copy of the CMS-1500?
Whether or not you want to save a paper copy of the CMS-1500 for your records is up to your preferences and policies. Therabill will store a digital copy of the CMS-1500 in your CMS-1500 filing cabinet. You can access past claims at any time by logging in to Therabill and clicking Filing in the top navigation bar. Paper claims will have the status bar to the left of the claim be colored coded gray (and it will always be gray).
Do I receive status updates on paper claims within Therabill?
Only claims that you submit electronically have electronic status updates delivered to you. Claims that are submitted by paper will not receive these status updates. In your filing cabinet, the claim will not go through the different color codes that electronic claims go through. A paper claim will be gray in your filing cabinet and that color code will never change (unless you change it to an electronic submission).
I created a paper claim but would like to submit it electronically, can I do this?
If the insurance company that you submitted to has the option to submit electronically (the lightning bolt icon was available) but you clicked the PDF icon for a paper claim, then you can change it to an electronic submission. You can do this from your filing cabinet. In the top navigation bar of Therabill, click the Filing button to go to your CMS-1500 filing cabinet. Within your filing cabinet, find the claim that you submitted by paper and then click the tools icon associated with that claim. In the menu that opens, choose Submit Electronically. This option will only be available if claim was initially submitted by paper.