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Claim Templates

How to create new Claim Templates and what to do with them once you have them.

Aubree Dorr avatar
Written by Aubree Dorr
Updated over 2 months ago

Start your medical billing workflow off right with the library of DocStation Claim Templates and templates specific to your own organization, one of the features available with the DocStation Essentials and Premium subscriptions. 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:

  1. Navigate to Organization Settings with the Settings gear in the left navigation menu.

  2. Navigate to the Templates tab to access the library of Templates.

  3. Click the blue + in the top right corner.

  4. Enter all pertinent details for the template, including:

    1. template type (required)

    2. title (required)

    3. type of plan (required)

    4. specific payer/health plan (optional)

    5. provider and service facility details (optional)

    6. service code(s) (required)

    7. service fee (required)

    8. diagnosis codes (optional)

    9. service modifiers (optional)

    10. place of service (optional)

  5. Choose the corresponding type for the service or product you'd like to bill:

    1. Basic Fixed Cost: used to bill for services when the charge amount stays the same across all claims generated from the template

    2. Basic Product: used to include the product NDC when billing J-codes

    3. 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)

    4. 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)

    5. 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.

  6. Once the template has all of the pertinent details, click Create Template.

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. 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.

When a template is in use in a claim, all fields are modifiable as needed.

Have more questions about claims or templates? Reach out to the DocStation team in the chat bubble on the platform!

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