Insurance & claims
Insurance paperwork, prepared carefully and labeled honestly.
Keep each client's policies on file, check eligibility, and build claims from completed sessions with diagnosis and CPT codes filled in. A readiness check catches missing details, and a CMS-1500-style view lets you review or print a claim before it goes anywhere. With a Stedi clearinghouse account connected, eligibility checks and claims go out electronically, and acknowledgments and payments come back on their own.
Why it helps
What it does for you
Client policies
Payer, member ID, group number, subscriber details and copay, with primary and secondary coverage.
Eligibility checks
Check coverage for a policy and keep the latest result on file, with the date it was checked.
Claims with a readiness check
Claims start from a completed session. Tidemend flags anything missing, like an NPI, tax ID, address or diagnosis code, before you go further.
CMS-1500-style review
See the claim laid out the familiar way to review it, or print it.
Draft 837P export
Export the claim as a draft 837P file to validate with your clearinghouse.
Claim history
Track each claim from draft to paid or denied. Acknowledgments and payment reports (ERAs) update it on their own, and insurance payments post automatically.
How it works
A few steps, mostly out of your way.
Step 1: Add the policy
Record the client's coverage in their chart.Step 2: Check eligibility
Run a check and keep the result with the policy.Step 3: Build the claim
Start from a completed session; codes and dates carry over.Step 4: Review and export
Fix anything the readiness check finds, then review, print or export.
What’s included
- Client insurance policies
- Eligibility checks
- Claims from completed sessions
- Readiness check
- CMS-1500-style review and print
- Draft 837P export
- Claim status history
Good to know
- Without a clearinghouse account, Tidemend uses a mock clearinghouse so you can try every step with demo data. Eligibility results and claim statuses then come from that mock, not from a real payer.
- Real eligibility checks and claims go through Stedi once an account is connected. Payers may require enrollment first, especially for payment reports (ERAs). Secondary claims are printed for now.
- The 837P export is a draft. Validate it with your clearinghouse before submitting anything.
- Payer IDs in the picker are examples. Confirm them against your clearinghouse's payer list.
Try the claims workflow with demo data
Insurance tools are a proposed add-on to the Clinician plan and are included with Group. Try the whole workflow with demo data and the mock clearinghouse.
