Skip to main content

Insurance Claims

InSched provides tools for creating, managing, and submitting insurance claims for reimbursement of covered services.

Accessing Claims​

Select Billing > Claims from the menu to open the Claims management dialog.

Claims List​

The Claims dialog shows a grid of all claims with status tracking. You can filter and search claims by various criteria, and the grid supports conditional formatting to highlight claims by their current status.

Creating a Claim​

Claims are generated from charges that have insurance responsibility assigned. When entering charges (see Entering Charges), set the appropriate Insurance Responsibility checkboxes (Ins1 Resp, Ins2 Resp, Ins3 Resp) to indicate which insurance should be billed.

Editing a Claim​

Select a claim and open the Claim Editor to modify:

  • Patient and insurance information
  • Claim line items (procedures, diagnosis codes, modifiers)
  • Provider information
  • Submission details and tracking

Printing Claims​

The Claim Print feature generates claim forms for submission to insurance companies. Claims can be:

  • Printed on standard HCFA-1500 forms
  • Previewed on screen before printing
  • Generated for electronic submission

Claim Workflow​

  1. Enter charges with diagnosis codes and insurance responsibility
  2. Generate claim from the charges
  3. Review and edit the claim for accuracy
  4. Print or submit the claim to the insurance company
  5. Track status as the claim is processed
  6. Record payment when the EOB (Explanation of Benefits) is received
  7. Apply payment to the original charges
  8. Bill patient for any remaining balance

Billing Queue​

Select Billing > Billing Queue to view charges that are ready to be billed but have not yet been submitted as claims. This provides a workflow checkpoint to ensure all charges are captured before claim submission.