Create, validate, and submit the claim
By this point the claim mostly assembles itself. You review what's pre-filled, validate it, submit it electronically, and track it from Billing.
- A completed, attended appointment with a signed note and diagnosis (lessons 6.4 and 6.5)
- Your insurance foundation: billing profile, payers, enrollment, billable services (lesson 4.5)
Create and validate
- Open the completed appointment → View.
- Check the pre-filled client, payer, service, DX codes, and provider.
- Click + Add claim (or the arrow beside Create invoice → Create claim).
- Open the claim, complete anything missing, and click Validate.
Validation is your pre-flight check: it catches the errors payers reject claims for, while they're still free to fix. If the client owes a co-pay, Create invoice from the same panel.
Submit and track
Click Submit electronically and the status moves to Submitted. From there, everything is trackable in Billing → Claims: the status sits in the claim's header, the history icon shows payer messages, and status changes arrive as in-app notifications.
Only two statuses need anything from you. The rest (Validated, Submitted, Accepted, Paid, Partially paid, Processed) is just the claim moving through its lifecycle.
Secondary claims, and the RCM shortcut
If a client has secondary coverage, open the primary claim → Create Secondary Claim → choose the secondary policy → submit it the same way.
And if your practice uses Carepatron's RCM service, this last step is done for you: the billing team creates, checks, and submits claims, and works any rejections and denials. Everything earlier in this course is still your side, because that's exactly what the billing team builds from.
Tick these off in your own workspace before moving on.
Three ways practices run the claims desk.
Claims reward a steady routine more than heroic catch-up sessions.
The claim is created and submitted right after the note is signed, so nothing batches up.
The week starts in Billing → Claims filtered to Rejected and Denied. Rejections get fixed first, then denials are assessed for appeal.
When a primary pays, the secondary claim is created the same day, so coordination of benefits never stalls.
Can I submit while payer enrollment is still pending?
Yes. The enrollment documents wait for approval, but you don't have to hold your billing.
What do the other statuses mean?
Validated: ready, not yet sent. Submitted: with the clearinghouse. Accepted: the payer is processing it. Paid and Partially paid: payment received and linked. Processed: it came back on an ERA with zero payment after adjudication.
Can I file on paper instead?
Electronic is the fast path, but CMS-1500 claims can be exported and submitted manually when a payer needs paper.
What changes on Carepatron's RCM service?
The billing team submits the claims and works rejections, denials, and appeals. Your side is lessons 6.1 to 6.5: eligibility, correct booking and coding, documentation, and accurate statuses.