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Adding Claims to a Batch Claim

Office Puzzle lets you build a batch claim from four different sources, depending on where the data you need to bill is coming from. This article walks through each one.

Before you start: you need an existing batch claim. From the left menu, go to Billing > Batch Claims, then either open an existing batch or click + New Batch.

The four sources

Inside an open batch claim, click + Create. The Select Source window appears with four options:
Source
Use it when
UNBILLED_EVENTS
You want to generate brand-new claims from completed appointments/events that have not been billed yet.
DENIED_CLAIMS
You would like to rebill claims that came back denied or declined from the payer.
UNBILLED_CLAIMS
Claims already exist in the system but have not been attached to a batch yet.
MANUAL
You need to key in a claim by hand.

Note: a batch claim is tied to a single payer and clearinghouse. Only records that match the batch's payer will be available to add.

Source 1 — UNBILLED_EVENTS

This is the most common path: it turns completed service events into claim lines.
 

Step 1 — Set your filters

After selecting UNBILLED_EVENTS, the Select Filters window opens. Choose the date range for the events you want to bill, then narrow the search with any of the optional filters:
  • All providers

  • All credential types

  • All payers

  • All clients

  • All event types

  • All billing codes

  • All Document Status

Leaving a filter untouched includes everything. Click Continue when you are done.
 

Step 2 — Wait for the search to finish

Office Puzzle runs the search in the background and shows a Tasks Manager window with a Preview Events task and a progress bar. You can follow progress on the Running tab and switch to Completed when it finishes. Stop cancels the task.
  • Tip: the Tasks Manager runs in the background, so a large date range will not lock up your screen.

Step 3 — Select the events to bill

The Select events window lists the matching events grouped by client, with Min date, Max date, Total hours, Total units and # of events for each one.
Expand a client with the arrow on the left to see every event behind the total: date, type, time, location, hours, units, client, user (provider), billing codes, prior authorization and status.
Use the checkboxes to pick the events you want. Select the client-level checkbox to take all of that client's events at once, or check events individually. The Continue button shows the number selected — for example Continue (6).
  • Export downloads the event list shown on screen, which is useful for reviewing units and hours before you bill.

Step 4 — Configure how claims are generated

The Claims Setup window controls how the selected events are grouped into claims. By default, all events are added to a single claim per client, each event as a line item. You can override this by splitting:
  • Split by Provider

  • Split by Credential

  • Split by billing code

  • Split by Place of Service

Set each option to Yes or No and click Continue.
 

Example: if a payer requires separate claims per rendering provider, set Split by Provider to Yes and Office Puzzle will create one claim per provider instead of one per client.

Step 5 — Review and add the claims

Office Puzzle generates the claims and shows them in a Select Claims window with a summary header — total Amount, claims_count, lines_count, Clients, Prior Authorizations, Insurances, Payers, Users and Billing codes — followed by the claims themselves.
Review the list, keep the claims you want checked, and click Add (n). The claims are added to the batch and the batch totals update.
 

Source 2 — UNBILLED_CLAIMS

Use this when the claims already exist but are not yet in a batch.
 
Click + Create and select UNBILLED_CLAIMS.
 
In the Select Claims window, set the date range and, optionally, pick a client. Click Search.
 
Review the results. The summary header shows the totals for the claims found.
 
Check the claims you want and click Add (n).
  • Tip: hover the status icon at the left of a row to open the Alerts panel. It tells you whether the claim has validation errors before you submit it — "No errors found" means the claim is clean.

 

Source 3 — DENIED_CLAIMS

Use this to rebill claims the payer denied.
 
Click + Create and select DENIED_CLAIMS.
 
Set the date range and, optionally, a client, then click Search.
 
The results list every claim in a DECLINED status within that range, with its client, payer, insurance ID, prior authorization and amount.
 
Check the claims you want to rebill and click Add (n).
 

Before rebilling: open the claim's Alerts panel and fix the reason for the denial (authorization, insurance ID, billing code, place of service) so the claim does not come back denied a second time.

 

What happens next

Once the claims are in the batch, the batch moves through its lifecycle: CREATED → CONFIRMED → SUBMITTED → PAID. From the batch detail screen you can also Change Status, Delete, Print or Create Invoice from the selected claims.
 

Troubleshooting

Problem
What to check
"No records available" after searching
The date range may not cover the service dates, or the batch's payer does not match the records you are looking for. Widen the range and clear the client filter.
Expected events are missing from Select events
The events may not be in a billable status (for example, not COMPLETED), or they may already be billed on another claim. Check the All Document Status filter.
Too many or too few claims were generated
Review the Claims Setup split options. Splitting by provider, credential, billing code or place of service changes how many claims are created.
A claim was added but shows an alert
Open the Alerts panel on the claim row to see the validation errors before submitting the batch.