Once notes are signed by the therapist, claims will will go to the Billing Queue for review. When are ready to submit claims, you will do so from the Billing tab. The direct link is here: https://app.stridethera.com/billing/claims/billing-queue
The Billing tab is meant to a catch any potential billing errors - such as, missing authorization (if one is required), incomplete information (e.g., referring provider, insurance details), missing insurance holder information, etc. Once the claim has passed validation, you can submit it for processing. If you have Stride billing, this will move the claims to the 'Ready to Submit' bucket within the Claims tab.
There are two types of flags you may see within the Billing Queue:
- Yellow Flags
- Red Flags
Example Red Flag Errors:
- Click into the claim details to see potential errors, you can do so by clicking on the hyperlinked DOS. As seen in images above, 'Red Flags' may occur for missing authorization, missing insurance details like, gender, missing member ID, missing address information or missing insurance policy holder information. All of this information can be updated within the patient's chart and/or insurance information.
- Once the correction has been made, click on the DOS > Refresh Claim Info to clear out alerts that have been resolved. If the alert has not cleared out, there is still information missing.
- If authorization or referring physician is missing and it is not needed for the patient's insurance, you may want to check your Payer Settings or the information with the patient's Insurance Details.
Video demonstration on updating and refreshing claims:
Yellow Flag Errors:
Yellow flags will occurs as a result of an amended note. Once you click into the claim, you will see 1 of the 2 messages below depending on the claim status.
For more information on how to resolve the Yellow Flags, please read this article: https://stridetherapy.zendesk.com/hc/en-us/articles/39754138392083-Resolving-the-Existing-submitted-claim-is-not-in-an-actionable-state-alert