Generate a Claim from a Visit

Claims are built from visits, so a claim says what its visit says. Generating one yourself is how you rebuild a draft from the visit on purpose.

Before You Start

You need the User role and a visit whose readiness is satisfied. The visit page lists anything still missing.

Generate

1. Open the visit.
2. Check the readiness summary and resolve anything it lists. A service with no charge fails Services Priced, and Generate Claim stays greyed until it has one. Select Enter Charge → to add it. A visit still waiting in Coding Review fails Coding Released in the same way.
3. In the Claims card, select Generate Claim.

Result: a claim in Draft, built from the visit’s services, provider and coverage, ready to be checked.

Regenerating Overwrites Your Edits

If a draft claim already exists, Generate Claim rebuilds it from the visit. Any field edited by hand on the claim is replaced by what the visit says, so ClaimPod asks you to confirm with Regenerate Claim first. The automatic refresh that runs after an import or on a schedule is different: it keeps lines you edited or added by hand.

Once a claim on the visit is past Draft and not voided, Generate Claim stays greyed until you revert that claim to Draft on its own page. A filed, unpaid primary billed to the wrong coverage is rebilled from the claim with Rebill to Another Payer, not regenerated.

That is the intended direction, and The Claim Loop explains why: the visit is the source of truth, so a correction belongs there rather than on each claim built from it.

Tip

A claim that keeps failing review on provider or location details is telling you the source record is wrong. Fix the provider or location once and every future claim inherits it.

Related: Check and Fix a Claim · Patients · The Claim Loop