Filing an Insurance Claim | Suno Help Center

This guide will walk you through the steps needed to file an insurance claim for an invoice using our system. Follow these step-by-step instructions to ensure a smooth submission process.

Step 1: Locate the Necessary Invoice

Navigate to the patient profile.
Find the invoice in the Patient Billing section.
Alternatively, access the invoice from the Billing module.

Step 2: Prepare the Invoice

Ensure the invoice payment source is set to Insurance.
Select the appropriate insurance policy (Note: An insurance policy must first be added to the patient's Insurance Policies section in order to be selected).
Verify that all line items to be submitted to insurance have correct CPT codes and modifiers.
- In order to add a CPT code, you can click on Select CPT and then search either by the name or CPT code.
- In order to add modifiers, you will need to select the + Modifiers option and add the modifiers as necessary.

Step 3: Update Billing Status

Save the information.
Change the billing status to Ready to Bill.
Click on the three dots to the right of the invoice.
Select File Insurance Claim.

Step 4: Complete the Insurance Claim Workflow

ICD-10 Codes: If the invoice is attached to an appointment, codes will auto-populate from the associated appointment's chart note. If there were no ICD-10 codes attached to the invoice/appointment, then you can add these manually as needed.
Note: You'll notice that each ICD-10 code added gets a letter associated with it. This is how the codes will be matched to the DIAG REF field for the line items.
Primary Insurance: Auto-populated from invoice settings; adjust if necessary.
Additional Options:
1. Include prior-authorization codes (these are created under the patient's Insurance Policies section).
2. Add additional insurance if necessary.
3. You can choose to include the Referring Physician. Note: If the referring physician's NPI number is not included, you will see a small warning indicating this; the NPI number is required for referring physicians when submitting claims.
4. You can also opt to Use Unit Prices.
  - Note: Use Unit Prices will submit the full amount of the line item before any discounts were applied.
5. The Accept Responsibility option indicates to the insurance company whether or not you will accept their assignment on the claim:
  - Yes: Indicates that you will automatically accept their assignment and adjustments on the claim.
  - No: Indicates that you will not automatically accept the assignment and will need to continue negotiating with the insurance company to receive payment. This also means you become an Out-of-Network provider for the claim.
6. For Medicare claims, you can select the Medicare Type Code to be submitted with the claim as well.

Step 5: Review and Adjust Line Items

View all line items set for submission.
Deselect any line items that are not to be submitted.
- Note: When filing insurance claims with binaural CPT codes, you will want to ensure that only one of the line items with the CPT code is selected. For example, if you have two hearing aids with the same binaural CPT code, then you will deselect one and then update the cost of the submitted line item to reflect the cost of both hearing aids as shown below:
CPT codes and modifiers will auto-populate from the invoice, though you can add last-minute modifiers.

Step 6: Finalize the Insurance Claim

Diagnosis Reference (DIAG REF): Reflects the corresponding ICD-10 codes; adjust as needed.
Modify the Charges amount for each line item if necessary.
Once all information is correct, select Submit to Claim.MD at the bottom of the workflow.

For further assistance, please contact our help desk.

Creating a New Invoice

Insurance Payments and Adjustments

Filing Insurance Claims for Binaural Hearing Aids

All Staff Training

Verify Insurance Eligibility with Claim MD