Generate/Process Insurance Claims

Titanium allows users to print hard copy insurance claim forms using pre-printed CMS 1500 paper.  This feature is activated and set up by your center administrator.  Prior to generating claims, users who bill insurance may also have to update their user settings, depending on choices made by the center administrator.

Titanium does not electronically interface with any third-party insurance clearinghouses, but claim information can be exported as print image files which might be suitable for upload to some third-party clearinghouses.

What would you like to do?

Add Client Insurance Information

1.   Navigate to the billing file screen or client record by:

2.  Click the Client Insurance icon on the menu bar or button on the client screen.

3.  Click Edit.

4.  Click Select to enter the insurance carrier:

5.  Use the pull down menus and text boxes to enter the client's insurance information.

6.  Enter a prior authorization number and number of visits, if applicable.  (Note:  Titanium will not perform any automatic calculations using this information.)

7.  Enter the client's co-pay type (flat rate or percentage) and rate or percent.  (Note:  Titanium will not use this information to automatically calculate the client's co-payments.)

8.  Click the Other Insurance Details tab, and use the pull down menus and text boxes to enter information required on insurance claims.  (Note:  You should consult with your center administrator or use the state or federal guidelines for CMS 1500 claim forms to learn more about these fields.)

9.  If the client has secondary insurance, click the Secondary Insurance tab and enter information.

10.  If desired, attach a scanned copy of the client's insurance card by clicking Insurance Cards, and using the Windows interface to navigate to the desired file.  Enter the file name, and click Ok.  (Note:  To manage insurance cards, right click on the card and choose Delete, Edit Description, Open or Print.)

11.  Click Save.

12.  Click Exit.

Edit Client Insurance Information

1.   Navigate to the billing file or client record screen by:

2.  Click the Client Insurance icon on the menu bar or button on the screen.

3.  Click Edit.

4.  Click the desired tab, and edit the information.  (Note: Click Clear All on the menu bar to remove all client insurance information.  To clear information for a single tab, delete the carrier.  If the secondary coverage has become primary, click Swap on the menu bar to switch the order in which claims will be submitted.)

5.  Click Save.

6.  Click Exit.

Review Client Insurance Information

Generate Bulk Claims

1.  From the schedule screen, click Open > Insurance Claims Needed.

2.  If desired, used the date filters to search for desired claims (e.g., last month).

3.  Click on the Claim Issues tab to resolve problems with claims:

4.  When the Pending Claim Issues tab is blank, click the Ready for Generation tab.  Click the check box next to the desired claims from the list or the Select All icon on the menu bar.

5.  To preview claims, click the Preview icon on the menu bar.

6.  To generate claims, click the pull down arrow next to the Generate Claims icon on the menu bar and choose whether to export or print claims

Generate Claims for One Client

1.   Navigate to the billing file screen by:

2.  Click on the Pending Claim Issues tab to resolve problems with claims:

3  When the Pending Claim Issues tab is blank, click the Claims Pending Generation tab.  Click the desired claims from the list.

4.  To preview claims, click the Preview icon on the menu bar.

5.  To generate claims, click the pull down arrow next to the Generate Claims icon on the menu bar and choose whether to export or print claims

Process Claims

Titanium contains claim actions that you will use to track claim status.  On the Record of Account tab, each service line used to generate a claim will show the claim action or amount paid by insurance after the claim is marked complete.  On the Insurance Claims tab, each insurance claim shows the status, as well as subsequent related claims (e.g. resubmit, cancel/void).

Claim actions mirror the claim life cycle and include:

The current claim action will be displayed next to the claim, and on the Record of Account under the insurance column(s) for each service line item included in the claim.   To change a claim action:

1.   Navigate to the billing file screen by:

2.  Click the Insurance Claims tab.

3.  Right click on the insurance claim, and choose the desired claim action.  If required, enter a reason for the action and click Ok.  (Note:  If the claim action does not follow the claim life cycle, you will see an information window explaining the next step.  Click Ok to close the window.)

4.  To undo a claim action, right click on the claim and click Undo.  The claim will be returned to its former state.  If required, enter a reason for the action.