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This article provides step-by-step instructions on how to set up a superbill, file a claim, submit a claim, and change fees in Elation Billing.

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Overview

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What is Filing a Claim?

Filing a claim is the process of creating and submitting a superbill in Elation Billing to request reimbursement from insurance payers or patients for services rendered.

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Why is Filing a Claim important?

Properly filing claims ensures that your practice receives timely and accurate reimbursement for the healthcare services you provide. It also maintains accurate billing records and supports efficient revenue cycle management.

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Workflow Instructions

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Integrated/AiO Claims Creation

Typically*, AiO claims will be created in Elation Billing once the Visit Note with Billing Information has been Signed in the EHR. If you have Delayed Billing activated in the EHR, you can scrub and transmit the signed notes via Billing Home.
Any edits made to a Note in the EHR after it has been sent to the Billing Software must also be manually updated within the Billing Software.
Once the claim has been created and reviewed in Elation Billing, proceed to Step 8 - Lightning Bill of these instructions. *For claims that need billing and are not tracked in the EHR, follow the steps below!

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Creating a Superbill in Elation Billing

  1. Navigate - Hover over the Billing tab and select + New Superbill.
  2. Add the Patient - Under NEW SUPERBILL, click the blue Add Patient button. At this point, you can either Select an existing patient, or Add a New Patient. To quickly find an existing patient, you can use the Search bar and search by First Name, Last Name, or DOB (YYYY-MM-DD), and then click SELECT on the patient required. Once you have Selected the patient, you have three new options - (L to R) Copy Claims, Edit, and Swap Patient
    • Copy Claims - Select this to view previous claims for this patient. Select the Charges tab for the opportunity to select a previous claim for this patient and copy ALL of its attributes to this new Superbill.
    • Edit - Update the Patient Details stored within the Billing Software.
    • Swap Patient - Select a different patient to apply to this Superbill. Note: this option will disappear once you Add a Claim Line to the Superbill.
  3. Insurance Coverage - Once you have selected the patient, their Insurance Coverage will populate in the middle of your screen. From here, you can view and edit the Patient’s Insurance and Authorization information, as well as update the Eligibility. (To view Authorizations, select Auths, detailed in the next step) Buttons (L to R) - Edit Insurance, Insurance Notes, Deactivate Insurance
    • Edit Insurance - Update the Payer, Priority, Member ID, and Group Number. Select SEE MORE to add Coverage Start and End Dates*, Patient Relationship to Insured, Insured Info (if not Self), and Medicare Secondary Codes (only for use on Medicare policies in Secondary). *Please note that at this time the Coverage Start and End Dates only serve a clerical function - the billing software will always bill to whatever Active policy you’ve selected when you Bill, rather than automatically routing to a payer based on Start/End Dates.
    • Insurance Notes - Add a Note for the Insurance selected. Remember that this is not patient specific - this note will be seen throughout the billing software when this Insurance is selected.
    • Deactivate Insurance - Rather than Deleting the insurance, this moves it from Active to Inactive. This maintains a record of previous policies, while letting the billing software know which policies it can ignore when it comes to routing a claim.
  4. Authorizations - To view Authorizations on file, select Auths. From here, you can add, view, and edit authorizations on file for the patient. To add a stored Auth to a specific claim, select Add Authorization in the green Copayment Collected box (see step 5). The billing software will automatically count down the amount of Authorizations that have been attached to claims to help let you know when it’s time to request a new one!
  5. Rendering, Location, From/Thru Date, Copayment Collected - This is also where you’ll:
    • Add a Supervising Provider
    • Add a Referring Provider
    • Add Authorizations already on file
    If you’d like, you can establish a Default Provider and/or Location in the Claim Defaults tab of your Practice Settings. While establishing these rules will automatically populate the Rendering and/or Location, note that you can always change these on a claim-by-claim basis. Use Copayment Collected to denote copayment taken at time of service - this will create a Payment in the billing software attributed to the Patient, to be applied at a later date.
  6. Add Claim Lines/CPTs - Select Add Claims to start adding your Procedure Codes.
    Selecting Add Claims will generate a Superbill ID number for this claim, which can be found above the Patient Name in the upper left of the Superbill. This is also when the Claim will begin to Auto-Save every change you make!
    Within the pop-up, add as many CPTs as you need, making sure to press [Tab] or [Enter] after each code to register it to the Claim. If you add the wrong one, click the x next to the code to remove it. When you’re all done, click Save. Note that clicking on the CPT as shown below will display more information about the CPT. The same is true of DX codes.
  7. Add Modifiers & Diagnosis Codes - Now that you’ve got your CPTs added, you can update the From/To dates on a Code by Code basis, add any needed Modifiers, update the Units and Charge, and add up to 4 Diagnosis Codes. You can add Diagnosis Codes by either typing them in, selecting SAME to add the same Dx as appeared on the last Superbill, or by selecting them via Add. Using Add allows you to view recently used Diagnosis codes, as well as search for Diagnosis codes for more information. You can add Modifiers by typing either the modifier number itself, or by searching for words relevant to the modifier needed. (Optional) Claim Notes, Correct Claim Info, Claim Narrative and More Fields More Fields is where you can enter additional information about specific claim types, such as workers’ compensation claims. This includes details like the Date of Injury and Location of Injury.
  8. Lightning Bill, Save, Worklist, Delete Lightning Bill Using the dropdown menu in the center of the pop-up, select where the claim will be routed (Primary, Secondary, Tertiary, or Patient) as well as the choice to either Mark As Billed or Bill Now.
    • Mark As Billed is to be used when submitting this claim through means other than electronic submission through the billing software - it will add Mark As Billed to the Claim’s History, along with a marker of which payer to which it was submitted.
    • Bill Now will send it to the Claims Queue, where it will await your final approval.
    Save - while the billing software automatically saves your progress as you edit a Superbill, Save offers peace of mind to those nervous about an auto-save. Worklist - If you are not ready to bill off this claim, Worklist allows you to set the Worklist Status to “Yes”, and select the tag(s) you would like it stored under. Delete - if this claim has yet to be billed off, it can be Deleted to scrub it from the system. If the claim has already been billed off, you will be unable to Delete the claim.
8a. Billing Validation - On selecting Lightning Bill, Elation Billing will conduct a preliminary check for required information. The following will be flagged if the fields are empty/missing:
  • Diagnosis Codes - if any charge line has no Diagnoses Code present
  • Patient Address - If the patient’s street, city, state, and/or 5-digit Zip Code are missing
  • Patient Insurance Member ID - if the patient’s Member ID is completely missing
  1. Bill the Queue - When you’re ready to transmit your claims to the Payers, you’ll need to Bill the Queue! From any page within Elation Billing, select Bill Now at the top of the page, confirming this choice in the pop-up that appears. If you would like to review the Queue before billing, you would instead select See Queue.