Start your medical billing workflow off right with the library of DocStation Claim Templates specific to your organization. Claim Templates are a great tool to consistently bill frequently provided services and health plans in a few quick clicks. Keep reading for step-by-step instructions, or check out this tutorial!
Creating a Claim Template
To create a new template:
Navigate to Organization Settings with the Settings gear in the left navigation menu.
Navigate to the Templates tab to access the library of Templates.
Click the blue + in the top right corner.
Enter all pertinent details for the template, including:
Template type (required)
Choose the corresponding type for the service or product you'd like to bill:
Basic Fixed Cost: used to bill for services when the charge amount stays the same across all claims generated from the template
Basic Product: used to include the product NDC when billing J-codes
Basic Time Based: used to bill for traditional MTM services, calculates which codes and charge amount to submit based on time spent with the patient (indicated during the claim creation phase)
Complexity Based MTM: used to bill for traditional MTM services, calculates which codes and charge amount to submit based on the complexity level (indicated during the claim creation phase)
Dynamic Product: used for BIN billing, this template accesses the NDC-to-HCPCS mapping dataset to allow you to BIN bill any product and create medical claims using a single template.
Title (required)
Title according to the type of template. Ex (Vaccine consult, Hypertension consult, etc)
Type of plan (required)
List as "Other" unless the template will be used for Medicare or Medicaid claims
specific payer/health plan (optional)
provider and service facility details (optional)
service code(s) (required)
service fee (required)
diagnosis codes (optional)
service modifiers (optional)
place of service (optional)
Once the template has all of the pertinent details, click Create Template.
How to Edit a claim template
Your organization's templates can also be edited as needed by selecting Edit from the context menu (...) on the right side of the template card.
Once created, Claim Templates are available for use by anyone in your organization and can be used for on-demand claim submission as well as automated billing.
When a template is in use in a claim, all fields are modifiable as needed.
📌 If you submit a claim to a payer before the Electronic Remittance Advice (ERA) for that payer is approved, the claim will not be automatically updated on your dashboard. The pharmacy would be responsible for manually updating all claims submitted prior to ERA approval.
Pharmacies will receive a mailed copy of the Explanation of Benefits (EOB) for each claim. Claim statuses can also be accessed from the direct Payer Provider Portal or Clearinghouse. Check out this article on how to update your claims!
If you do not know if you have an ERA on file, send us a message through our Chat bubble!
Have more questions about claims or templates? Reach out to the DocStation team in the chat bubble on the platform!