Submit your first claim, end-to-end
From visit close to recording the payer's payment — every step in order with the gotchas called out.
- Updated
- Updated
- Reading time
- 8 min read
- Tags
- claimbillingfirst-time
This walks the path: superbill → claim draft → pre-submission check → submit → payer response → payment. Do it once on a friendly test patient before going live, and you'll know exactly where every status badge will sit on the day a real one matters.
Capture the superbill
On a signed note, the diagnosis and CPT codes auto-flow into a superbill. Verify modifiers, units, and place-of-service. The most common mismatches we see — and the ones the payer will reject without ever paying you — are: a telehealth code (90837, 99213, etc.) sent without modifier 95, an in-person POS 11 paired with a telehealth code, units that don't match the time documented in the note. Five seconds of verification here saves a denial cycle later.
Check the claim before you file it
Open the claim and choose Submit claim. Before you pick a filing method, EnWella checks the claim for what a payer would send back: no primary insurance policy on the claim, a payer that is not matched to the clearinghouse, no diagnosis, service lines that bill nothing, a rendering provider with no NPI on file, and anything else the clearinghouse's claim format requires. The dialog lists what it found. Electronic filing stays unavailable until every item is fixed, and until the practice's own clearinghouse setup is complete; you can still record a paper filing, except that a claim with no diagnosis cannot be filed either way. The check does not look at modifiers, place-of-service pairing, eligibility or prior authorization — verify those on the superbill.
Submit and acknowledge
Tap Submit. The claim goes to your clearinghouse within 60 seconds and the status badge flips to Sent. The next status — Acknowledged — comes back from the payer once they've accepted the file format and patient match (usually under 24 hours; some Medicaid plans take 2–3 business days). If a claim sits in Sent for more than 48 hours without acknowledgement, open it; the clearinghouse rejection (if any) is shown inline with the original submission for easy editing.
When the ERA arrives
Days later (typically 7–14 for commercial plans, longer for Medicaid), the payer sends back a remittance advice — an ERA, or an EOB on paper. EnWella does not fetch or post it for you. Open the claim, choose Record payer response to set the payer's answer, and Edit payment values to enter what the payer paid, what it left to the patient, and any write-off. The claim moves to Partially Paid or Paid as those amounts cover what was billed. The patient's share becomes their invoice when you record it.
When a denial comes back instead
Not every claim pays. Denied and rejected claims are listed in Billing → Denials, where you can filter by status and by denial reason. A denial has two ways forward: correct the claim and resubmit it as a replacement, or appeal. Appeals are filed with the payer — through their portal, by fax or by mail — not through EnWella; once yours is filed, open the claim and choose Mark appeal filed, and the claim goes back to pending with the payer. The deeper playbook lives in the Handling denials article.
Frequently asked questions
What if eligibility shows the patient is not covered?
How do I appeal a denial?
Was this article helpful?