Insurance Functions -- Terminology and Concepts

Familiarize yourself with the following terms and concepts you encounter when using the insurance functions:

Manual Claims

Claims that you enter one at a time. The software supplies patient/responsible party/insurance information, if available, and you enter specific treatment details.
Automatic Claims

Claims created by the software when you post a procedure or enter a contract. You must configure several areas of the software in order to use the Automatic Claims feature.
Electronic Claims

Claims that are submitted electronically to a clearinghouse, checked for errors, and then sent to individual carriers.
Clearinghouse

A holding facility where all claims are transmitted and then checked for errors. Claims that are error-free are then transmitted to the individual carriers for processing. Claims that have errors or are missing information are rejected, and the office can retrieve a report, detailing which claims are rejected and not forwarded to the carrier.