Use Claims to create, submit, and track insurance claims for patients.
Review the patient overview
The top section helps you confirm the patient and payment method before billing.
Profile Data: Review the patient's name, date of birth, and contact information.
Payment Method: Choose Insurance or Private Pay.
Insurance Snapshots: Review the member ID and payer name. Select Edit Patient Details to change the address or insurance plan before submitting a claim.
Use the Claims tabs
Unbilled Services
This tab shows services that have been documented but not sent to insurance.
A saved Billable Note creates an unbilled service automatically.
For a visit documented outside Allia, select + Create New Service and enter the session details.
The table shows Date of Service, Primary Service, Payer Name, Service Charges, and Actions such as Initiate Claim, Edit Draft, and Delete.
Important: Before selecting Initiate Claim, confirm the diagnosis for this session, add any required modifiers such as Modifier 95 for telehealth, and review the service charge. Charges come from the Enrollment Fee Schedule and appear as $0 when rates have not been set.
Submitted Claims
After submission, the service moves to this tab.
Track Claim: Review real-time payer updates.
Status Indicators: See whether the payer marked the claim Accepted, Pending, or Rejected.
Superbills
Use this tab for out-of-network patients who pay you directly and request reimbursement from their insurer.
To create a superbill:
Select a service.
Select + Create Superbill.
Download the PDF to give to the patient.
Payments
This tab tracks payments from payers and patients.
Reconciliation: Compare Service Charge, Insurance Paid, and Patient Paid.
Write-Offs: Allia calculates write-offs from contracted rates.
Send Invoice: Send an outstanding balance through Stripe. The patient receives it in the Allia Messaging tab and by email.
Invoice status appears as Sent, Paid, or Overdue.
Create and submit a claim
To create a claim:
Select Billing from the left sidebar.
Open Claims.
Select + Create New Service.
Complete the required information in the window.
Select Initiate Claim.
Review the information populated at the top of the claim form.
Add the appropriate diagnosis or diagnoses with the diagnosis search box.
Review the remaining claim information and enter the payer charge in Charge Amount.
Select Save as Draft.
Open Submitted Claims to track the saved claim.
Note: Diagnosis F codes appear without periods. For example, F41.1 - Generalized Anxiety Disorder appears as F411 - Generalized Anxiety Disorder.
Tip: Select View Details to save the diagnosis to the patient's profile so it populates on future claims.
