From signed note to superbill and claim

Once a visit is documented and signed, its billing is assembled here. The visit's Billing tab is the bridge between the clinical record and the money — it gathers the service, the quote, and the superbill that a claim is built from.

The visit Billing tab

Open the visit and go to Billing in the Admin section of the sidebar.

Four things sit on this screen:

• Service — what was delivered and its price, e.g. Manual Therapy Session, US$100.00.
• Quote — an auto-generated estimate, e.g. BQ-000016, in Draft. This is the patient-facing price before anything is billed.
• Billing — links a charge to the visit. Until then it reads "No billing is linked to this visit yet."
• Superbill — "a CMS-1500-style billing summary frozen from this visit."

Auto-charge this visit collects chargeable invoices from a card on file. It stays off until the patient has a saved card — the panel says so: "Add a card on file for this patient before enabling auto-charge." Adding a card and taking payment is a patient-authorized step, not something to enable silently.

Creating a superbill

A superbill is the billing snapshot a claim is built from. Create superbill freezes one from the visit.

There's a prerequisite worth knowing: the visit must be Completed. On a scheduled or in-progress visit the button is disabled. Complete the visit first — which, with the note required billing rule on, means the note must be signed. So the real order is: sign the note → complete the visit → create the superbill.

Once created, the superbill appears with a draft number, e.g. SB-00001.

It carries everything a CMS-1500 needs:

• Patient — name, DOB, address.
• Provider — the rendering clinician with their NPI.
• Practice — your organization and address.
• Date of service and Place of service code.

Reading the line items

Scroll to the line items — the billable procedures.

Each line shows the CPT code, description, units, fee, and amount — e.g. CPT 97140, Manual Therapy Session, 1 unit, $100.00. The CPT code comes from the service's Billing tab (see Setting up services), which is why setting those codes up front matters: they flow through to here automatically.

Diagnoses appear above the line items. If the visit had none charted, it reads "No diagnoses on this superbill" — and a claim without a linked diagnosis will usually reject, so add diagnoses on the visit before finalizing.

Frozen snapshots

A superbill is deliberately immutable. The screen states it: "The snapshot is frozen — there is no edit. To change anything, edit the visit, void this draft, and recreate."

This is a feature, not a limitation. A superbill is a point-in-time record of what was billed; letting it drift from the visit it froze would defeat its purpose. So the two actions are:

• Finalize — lock the superbill as the basis for a claim.
• Void — discard this draft. To correct something, void, fix the visit, and create a fresh superbill.

On to the claim

A finalized superbill is what a claim is generated from. From here the flow moves to the Claims queue: the claim inherits the patient, provider, codes, and amounts from the superbill, gets scrubbed against your billing rules, and is submitted to the payer through your clearinghouse.

Because submitting a claim sends real EDI to the clearinghouse and can't be undone from Ona, that step deserves its own care — covered in The claims queue, along with reading acknowledgements, rejections, and payments.

The full chain, end to end: signed note → completed visit → superbill → finalize → claim → submit. Each step gates the next, which is what keeps a claim from going out before the work behind it is documented.