Choose an Existing Patient
To see if your patient is already in our system, click into the "Patient's First Name" field to display a list of your existing patients. If the list is long, you can start typing their first or last name to narrow down your choices. Select a patient from the list to auto-fill their details. You will then only need to complete the "Visit Information" section of the form.
File a New Claim or Clone Their Most Recent Claim
If you choose an existing patient from your list, you will be prompted to either "Clone their most recent claim" or "File a new claim." If you choose to clone their most recent claim, all of the visit information except the date(s) of service will be auto-filled based on their most recent claim. You can edit all of their visit information on this new claim, if you wish.
If the patient for whom you are filing the claim does not appear in the list, enter their details as described below.
Enter a New Patient's Information
This is the person who received the treatment. Even if your patient is a minor (under the age of 18), their personal information should be entered in these fields.
Enter the Primary Policy Holder's Information
This is the person who is the Primary on your patient's insurance plan. If your patient is also the Primary on the insurance plan, check the box where it says, "The patient is the Primary Policy Holder" to auto-fill their name, date of birth and legal sex.
You can submit the form without providing the Primary Policy Holder's Insurance ID AND front and back images of their insurance card, but the claim will be saved as a Draft and will not be filed to the insurance company until those details are provided by either you or your patient (more on that, below).
Enter the Reimbursify Account Owner's Information
The Reimbursify Account owner is the person responsible for viewing and managing reimbursement claims, via the Reimbursify mobile app. They must be at least 18 years old. If your patient is a minor, their parent or legal guardian's information should be provided in this section. The email address that you provide in this section will be used to create a Reimbursify account for this person, and an email will be sent to them with usage instructions. If they already have an account, they will be notified via email and the claim that you filed will be visible to them in the Reimbursify mobile app.
Enter the Visit Information
Practitioner - Select the practitioner and visit location from list. If a practitioner in your group is not listed, you will have to add them to your group via the My Practice > Practitioners page.
Tax ID Number - If this field is blank, enter the Tax ID associated with the location where the visit occurred. If it is incorrect, you will need to correct it via the My Practice > Addresses page.
Date(s) of Service - Using the calendar, select the date or dates when the treatment was rendered. If you select multiple dates, individual claims will be filed for each date that you specify, with all of the same location, diagnosis, treatment and fee information. If you saw your patient on multiple dates where this information is not all the same, you will have to complete this form separately, for each variation.
Place of Service - Select from the options provided. Note: if you select the "Telehealth" option, a "95" modifier will automatically be added to each CPT code.
Diagnosis Code(s) - Your claim must include at least one valid diagnosis code (also known as an ICD-10 code). Click the "+ Add Another Diagnosis Code" button to add multiple codes.
CPT Code(s) - Your claim must include at least one valid CPT code (also known as a treatment code). Click the "+ Add Another CPT Code" button to add multiple codes.
CLIA Number (only necessary for lab claims) - If your treatment included a lab test, enter the CLIA number in the space provided.
Review and Submit the Claim
Once all of the fields have been completed, verify that the value displayed for the "Total for All Appointments" is equal to what you were paid, then click the "Submit Claim" button. If there are any errors on the form, a message will be displayed, directing you to the form fields that need to be corrected.
Email Notifications Sent to the Reimbursify Account Owner
If your patient's insurance information is already in the Reimbursify system, their claim will be filed and an email notification will be sent to the Reimbursify account owner associated with their claim. Here is an example of what the email that they will receive:
If your patient's insurance information is not in the Reimbursify system, their claim will be saved as a Draft and an email notification will be sent to the Reimbursify account owner associated with their claim. Here is an example of what the email that they will receive:
Viewing Submitted Claims
Submitted claims will immediately appear at the top of the list on the Claims page in the Practice Portal.
Draft claims will appear in a subsection of the Claims page, accessible via the "View Draft Claims" link at the top of the page, as illustrated below.
Editing Draft Claims
Click the "Edit" option next to any Draft claim to add your patient's insurance information and file the claim to their insurance company.
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