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How to create and submit insurance claims

Creating and submitting insurance claims electronically through Blueprint

Written by Aminda Villamagna

This article covers how insurance claims are created and submitted to insurance in Blueprint, plus answers a few common questions.


Prerequisites

  • Electronic claims must enabled for your practice in Settings > Billing

  • Before submitting a claim, confirm:

    • The client has active insurance information on their profile

    • The Progress Note for the session is signed


Creating claims

If a client has insurance information on their profile, a draft claim is automatically created after every session. Draft claims appear in two places:

  • On the Session Overview or that specific date of service (in the Billing tab)

  • On your Billing dashboard (in the Claims tab, under Needs Action)

You don't need to take any action at this stage -- draft claims will remain drafts until you submit them.

💡 What happens if the client doesn't have insurance on file?

Insurance information must be added to the client's profile before creating their insurance claims.

If the client doesn't have insurance on file, Blueprint won't create a draft claim for their sessions and the + Add invoice button on the Session Overview will be greyed out.


Submitting claims

Claims are submitted from the Billing tab of that specific session's overview page.

To submit an existing draft claim to a payer:

  1. From that session's overview page, click the Billing tab

  2. Click the draft claim to open it

  3. Review and edit the auto-filled fields if needed

  4. Click Submit claim at the bottom of the claim. (To save your edits without submitting, click Save instead.)

💡 You can also submit a claim using the "Finalize session with 1-Click" workflow!

The "Finalize session with 1-Click" workflow enables you to wrap up your session even quicker by completing all of the following actions in one step:

  • Signs and locks the Progress Note

  • Sends an invoice to the client (if applicable)

  • Submits the draft claim to insurance (if applicable)

📚 For full details, see [Using Finalize session with 1-Click].



FAQ

  1. How can I see a list of all of my current draft claims or search for a specific claim?

    Billing Dashboard > Claims shows every single one of your claims, with all draft claims listed in the Needs Action section.

    This is great place to see a full list of draft claims waiting to be submitted, or to search for a specific claim without navigating through each session individually.

  2. Why is the +Add claim button greyed out?

    On the session's Billing tab, the + Add claim button will be disabled and a tooltip will read No insurance on file. Add here. Selecting Add here takes you to the client's profile so you can add their insurance details.

  3. What kind of form is the claim?

    The form follows the CMS-1500 layout, with each field labeled by its box number:

    • Payer and Insured member ID (Boxes 1 and 1a)

    • Patient name, Patient info, and Patient address (Boxes 2, 3, and 5)

    • Insured's name, Patient relationship to insured, and Insured address (Boxes 4, 6, and 7)

    • Service line details further down the claim

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