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Insurance & claims

Eligibility, clearinghouses, superbills, and the claims pipeline.

7 articles

How claims move through OnaThe full journey of an insurance claim, from one-time setup through the per-visit gated sequence to payer response — the map for every other claims article.5 min read

Setting up insuranceThe foundation for everything insurance-related: organization, clinician, and facility NPIs, payer details, and what enrollments depend on.4 min read

Setting up your clearinghouseChoose and connect a clearinghouse, start payer enrollments early, and follow the ordered chain that ends with electronic claim submission.3 min read

Scrubbing claims with billing rulesCatch claim problems before submission with scrubbing rules — a rejection costs days, a rule that prevents it costs nothing.4 min read

Reading eligibility resultsRun real-time eligibility checks and read the 271 response — coverage badges, benefit details, and what an inconclusive result means.4 min read

From signed note to superbill and claimThe strictly gated chain from signed note to completed visit to superbill to claim — and why superbills are frozen snapshots.4 min read

Working the claims queueWork claims day to day: payer statuses versus workflow buckets, rejected versus denied, claim versions, and the clearinghouse audit trail.4 min read

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