How do I submit a claim?
Claims can be submitted through the portal for individual encounters.
Go to Claims and start a new submission
From the main menu, click Claims → New Claim. Claims can be submitted individually through the portal or in batch via 837P electronic file upload. This guide covers individual claim submission.
Select the member and encounter date
Search for the member by ID or name and select the correct member. Enter the date of service. The system will check eligibility automatically for the selected date. If the member was not eligible on that date, the claim will be flagged before submission.
Filing deadline — All claims must be submitted within 90 days of the date of service. Claims submitted after this window will be denied and cannot be appealed through the portal.
Enter service codes and charges
Enter the CPT procedure code, the corresponding ICD-10 diagnosis code, the number of units, and your billed charge. You can add multiple service lines to a single claim. The system will display the contracted rate next to each service code for reference.
Verify the authorization number
If the service required a prior authorization, enter the authorization confirmation number in the Auth Number field. The system will validate the authorization and confirm that it covers the submitted service type and date. Claims submitted without a required authorization number will be denied.
Submit and save the claim ID
Review all entries, then click Submit Claim. Save the claim ID that is generated. Standard claim processing time is 30 days from submission date. You can check the status at any time from the Claims dashboard.