One system, one record
Eligibility, claims, charting, and billing share a single patient record, so a claim is built from the same note the clinician already signed — no re-keying between an EHR and a separate billing tool.
Insurance
Real-time insurance eligibility and claims software, built into your EHR
Ona's insurance and eligibility tools run real-time eligibility checks and manage insurance claims inside the same EHR that holds the chart. Coverage status, co-pay, deductible, and out-of-pocket max surface before the visit; claims generate from the signed note, submit through an integrated clearinghouse, and track from draft to accepted or denied.
- Real-time eligibility checks
- CMS-1500 from the signed note
- Status pipeline tracking
- Denial & rejection workflow
Insurance and Eligibility is the revenue-cycle layer inside Ona's all-in-one practice management platform, which combines CRM, EHR, and RCM. It verifies coverage before the visit and works claims after it, so eligibility, benefits, and billing sit on the same patient record as the chart. Because it shares one system with charting and billing, service codes pull straight from the signed note into a claim.
It's for US practices that bill insurance — primary care, behavioral health, physical therapy, women's health, and similar specialties — including hybrid clinics that run cash-pay and insurance side by side. It fits solo clinicians and small teams who want eligibility and claims handled without buying a separate billing system.
01 · Why it matters
The co-pay conversation should happen before the visit.
A meaningful share of visit revenue leaks to eligibility errors discovered after service. Most are preventable.
When the front desk guesses at coverage, patients get surprise bills and practices write off chunks of every month. Auditing the guess after the fact doesn't fix anything — it just assigns blame.
Checking eligibility up front flips the order. Before the visit, Ona confirms active coverage and surfaces exactly what the patient will owe. No surprises at the desk, no write-offs on Friday.
02 · Why Ona
Insurance handled, not endured.
Answers before care
Coverage and cost show up before the visit, not after a claim bounces — active status, co-pay, deductible, and out-of-pocket max on the patient record.
Flexible by design
Mark a service cash-only, insurance-billed, or both; keep billing in-house or let an RCM partner work the same queue.
Medicare and Medicaid supported
Both are supported for eligibility checks and claim submission, with state-specific rules configured during onboarding where needed.
Status pipeline you can watch
Every claim moves through draft → submitted → acknowledged → accepted or denied. The list groups by status so nothing quietly ages in the wrong column.
Denials in a workable queue
Denied and rejected claims surface in the same list with payer reasons attached, and patient responsibility posts as a balance after adjudication.
03 · From booking to remit
The insurance lifecycle, demystified.
Run a real-time eligibility check
Active coverage status, co-pay, deductible, and out-of-pocket max return in a single sheet on the patient record. Failures surface up front, not at the desk Monday morning.Coverage lives on the chart
The latest eligibility result stays with the patient, so the front desk can quote the right co-pay before the visit instead of guessing.Generate the claim from the signed note
Signed services and diagnoses assemble into a pre-filled CMS-1500 (the standard professional claim form) draft — nothing re-keyed.Submit and track through the pipeline
Through an integrated clearinghouse, watching each claim move: draft, submitted, acknowledged, then accepted or denied.Work denials, resolve the balance
Denials and rejections land in a queue with payer reasons attached. Patient responsibility posts as a balance after adjudication.
“We went from running eligibility on a 3-day lag to real-time. Our bad-debt line dropped by half in two quarters.”
04 · In practice
Coverage, in the rhythm of your clinic.
Primary care + urgent care
High volume, fewer surprises.
Check eligibility as patients book and again at check-in when something feels off. The latest result stays visible on the chart for the whole team.
Specialty practice
One list for the whole billing queue.
Drafts, submissions, acknowledgements, accepted, denied, paid — all in a single grouped list. No one has to remember which tab a claim lives in.
Out-of-network / superbill
Itemised claims patients can self-submit.
An itemised CMS-1500 with diagnoses and service lines generates from the note. Share it with the patient so they can submit to their payer without calling the office.
Multi-provider clinic
Rendering provider kept straight.
Rendering NPI and provider billing config live in settings and flow into every claim. Who saw the patient, under which plan, always matches.
FAQ
Common billing-team questions.
Does Ona do real-time insurance eligibility?
Yes. Ona runs real-time eligibility and benefits checks against the major national and regional payers, returning active coverage status, co-pay, deductible, and out-of-pocket max on the patient record. If a payer isn't supported yet, our team can usually add it during onboarding.
Is this insurance claims software, or just eligibility?
Both. Ona generates a CMS-1500 claim from the signed note, submits it through an integrated clearinghouse, and tracks it through the status pipeline — draft, submitted, acknowledged, accepted or denied — with a denial and rejection queue in the same place.
Does Ona offer integrated EHR and billing?
Yes. Insurance, eligibility, charting, and billing run in one system, so service codes, labs, and prescriptions pull from the signed chart note into the claim and the invoice without switching tools.
Is Ona an all-in-one EHR?
Ona is an AI-native, all-in-one practice management platform that bundles CRM, EHR, and RCM — 19 tools on one platform — so scheduling, charting, insurance, and billing live on a single patient record. Every feature is available on every plan.
Does this replace our current billing service?
It can — the workflows are simple enough that many small practices run billing in-house on Ona. Higher-volume groups often keep their RCM partner and let them work inside the same claims queue.
Does Ona support Medicare and Medicaid claims?
Yes. Medicare and Medicaid are both supported for eligibility checks and claim submission, and services can be marked cash-only, insurance-billed, or both for hybrid practices. Some state-specific Medicaid rules are handled out of the box; others we configure during onboarding.
Ready when you are
Stop guessing at coverage.
Bring a real claim and a real denial to a fifteen-minute demo — we'll run both.