Manage Your Organization's Insurance Billing Settings

• Insurance billing settings apply to your whole organization.
• Claims can be submitted immediately, after a delay, or manually.
• Electronic claims are only created and submitted when all required data is present.
• Secondary claims are submitted automatically unless you turn that off.

• Submit electronic claim immediately after therapist signs documentation: Ambiki submits the claim as soon as the documentation is signed.
• Add a delay before each electronic claim is submitted: Ambiki waits 12, 24, 48, or 72 hours after the documentation is signed before submitting the claim. This gives your team time to review and correct claims before they are sent.
• Admin manually submits each electronic claim: Ambiki creates the claim but does not send it. A user with billing permissions submits each claim from the treatment report.

• The delay starts when the documentation is fully signed, not when the claim is created.
• If the documentation needs a co-signature or has an unsigned amendment, the delay does not start until the last signature is added.
• Ambiki checks for claims ready to submit every hour, so a claim goes out within about an hour after its delay ends.

• Automatically add the 59 modifier: When a patient has more than one treatment report on the same date of service, Ambiki adds the 59 modifier to the claims after the first one. This applies across speech, occupational, and physical therapy.
• Disable billing provider check before users can sign evaluation and visit note documentation: Lets therapists sign evaluations and visit notes that do not have a billing provider. Check this box only if your organization does not use insurance billing in Ambiki.
• Disable automatic secondary claim submission: Stops Ambiki from automatically submitting secondary claims when the primary insurance company pays. Secondary claims with errors are never sent automatically, whether or not this box is checked.

How Do I Change My Insurance Billing Settings?



Step 1: Open the Organization menu


At the top left of the page, click the Organization menu, then click Edit organization.

Step 2: Open EMR settings


On the left side of the page, click EMR settings.



Step 3: Find the Insurance billing section


Scroll down to the Insurance billing section.

Step 4: Choose a claim submission option


In the Electronic insurance claim submission dropdown, select how Ambiki should submit claims.

If you choose the delay option, select 12 hours, 24 hours, 48 hours, or 72 hours.

Step 5: Set the additional settings


Check or uncheck the 59 modifier, billing provider check, and secondary claim submission boxes as needed.

Step 6: Save your changes


At the bottom of the page, click Save organization.

Q&A


Q: How do I submit a claim when my organization uses manual submission?

A: Open the treatment report, click Invoice actions on the insurance invoice, and select Submit claim file. The option appears once the claim file is ready and has no errors.


Q: Why wasn't a claim submitted automatically?

A: Ambiki only submits a claim when all required billing data is present and the insurance company is set up for electronic claim submission. With the delay option, the claim also waits until the documentation is fully signed and the delay has passed. The treatment report shows when a delayed claim is scheduled to go out or what is holding it back.


Q: Can I stop one claim from being submitted without changing the organization setting?

A: On the treatment report, use Hold claim submission. The claim is not submitted, automatically or manually, until the hold is released. When you release the hold, the claim returns to your organization's submission setting.


Q: Does changing the delay affect claims that are already waiting?

A: Claims that are waiting on a delay use the delay saved in your settings at the time Ambiki checks them. If you switch away from the delay option, claims that were waiting are not sent automatically and must be submitted from the treatment report.


Q: Who can change these settings?

A: Users with permission to edit your organization can change insurance billing settings. If you do not see Edit organization in the Organization menu, ask your administrator.