Overview
Claims in Onvelas can be created directly from completed appointments (recommended) or manually from the Claims screen. All claims go through a scrub check before submission to catch common errors.
Creating a Claim from an Appointment
- Open the completed appointment.
- Click Generate Claim.
- Review the pre-filled data: CPT code, units, rendering provider, diagnosis codes.
- Add or adjust service line items if needed.
- Click Save as Draft or Submit.
Creating a Claim Manually
- Go to Billing → Claims.
- Click New Claim.
- Select the patient, payer, and date of service.
- Add service lines: each line needs a CPT code, units, modifier (if required), and charge amount.
- Add diagnosis codes (ICD-10) — at least one primary diagnosis is required.
- Select the rendering provider and supervising provider (if applicable).
- Click Save.
Claim Scrub Checks
Before submission, Onvelas runs automated scrub checks. Common issues flagged include:
- Missing or expired authorization
- Invalid NPI or taxonomy code
- Diagnosis code mismatch
- Duplicate claim detection (same patient, payer, DOS, CPT)
- Service date outside authorization dates
- Units exceeding authorized amount
Claims with scrub errors are held in Draft status. Resolve all errors before submitting.
Submitting Claims
- From the Claims list, select one or more Draft claims (use checkboxes).
- Click Submit Selected or open a single claim and click Submit.
- Claims are sent via your configured clearinghouse (ClaimMD by default).
- Status updates to Submitted with the submission timestamp.
Tracking Claim Status
Use the Claims list quick-filter pills to view claims by status:
- Draft — created but not submitted
- Submitted — sent to payer, awaiting response
- Denied — payer returned a denial; click to see reason codes
- Paid — ERA received and payment posted
- CH Rejected — clearinghouse rejected before reaching payer
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