# United States: CMS-1500 eClaims with ICD-10/CPT > Create CMS-1500 claims with ICD-10/CPT, submit electronically via clearinghouse, book insurer payments faster, and keep balances accurate with accounting/ERP sync The United States # Simplify **CMS-1500 eClaims with ICD-10/CPT** in Manage Generate CMS-1500 claims, e-file via clearinghouse, accelerate reimbursement, and reconcile accurately with accounting/ERP export. more Built-In Program Rules ## **CMS-1500 eClaims with ICD-10/CPT**—Accelerate Processing and Minimize denials Build CMS-1500 claims with ICD-10/CPT and send them electronically through your clearinghouse to speed processing and cut denials. - **Fewer denials** - ICD-10 and CPT coding plus automatic CMS-1500 field validation. - **Cut duplicate entry** - Patient, visit, and pricing details auto-populate from your workflow. - **End-to-end visibility** - monitor claim status from creation to approval or denial. ![USA Map@2X](https://www.auditdata.com/media/nadnuhca/usa-map-2x.png) ## CMS-1500 (HCFA) + ICD-10/CPT Build payer-ready claims with required CMS-1500 fields, accurate ICD-10 & CPT diagnosis codes, and CPT/HCPCS procedure codes. Patient, provider, and visit data prefill from your workflow to reduce manual re-entry, while inline validations flag missing NPI, place of service, or eligibility details before submission. The result is fewer first-pass denials and less back-and-forth with payers. ## Electronic Submission to Clearinghouse Auto-submit claims to your Waystar clearinghouse for faster handoff and reimbursement. Not on Waystar? Generate a CMS-1500 or 837P to submit to your clearinghouse or provider. ## Claim Status Tracking Track every claim from draft → submitted → paid/part-paid/denied with reason codes, dates, and notes. Aging views and follow-up queues prioritise the next best action, while user and timestamp history keep conversations short when finance or front office needs context. You always know what is waiting, why, and who owns the next step. ## Investigate & Resubmit with Confidence Transparent claim history tracks edits and status transitions end to end for fast investigations. Spin up a working copy from any version, fix the issue, and resubmit—keeping the original intact for audit and review. Accurate Posting, No Double Entry ## Apply Insurer Payments **Faster** Apply insurer payments in minutes and keep payer vs. patient balances clear across locations—while accounting sync and ERP/CRM integration remove retyping. - **Faster application -** Apply EOB amounts line-by-line without rebuilding the claim. - **Cleaner close -** Finish the day with Deposit registry & cash box and tidy totals. - **Consistent adjustments -** Govern refunds/discounts/tax so numbers stay reliable. ## Payment Application Tools Apply insurer payments at line level with EOB amounts, adjustments, and remark codes captured as structured data. Short-pay/write-off reasons are recorded, secondary balances update automatically, and staff see exactly what’s still due—without rebuilding the claim. ## Deposit Registry & Cash Box Close the day with totals by professional and location, variance flags, and a dated deposit log. Your hearing care professionals resolve issues before posting to finance, so end-of-day becomes a predictable, repeatable step across clinics. ## Refunds, Discounts & Tax Controls Permissioned workflows with required reasons and automatic tax calculation keep documents consistent and audit-ready. Avalara AvaTax adds real-time tax and address validation to reduce mis-taxed items and follow-up fixes. ## Finance Stays In Sync Export posted outcomes as journal entries and import them into your accounting system—keep ledgers aligned, reduce re-entry, and preserve a single audit trail from claim to close. Built-In Program Rules Simplify Managed-Care Rules to **Prevent Mistakes** Use Managed-Care price books to keep pricing and coverage consistent—so claims are right the first time. ## Managed-Care Price Books Enforce payer/plan rules and contracted rates automatically, including common modifiers and coverage limits. Quotes, invoices, and claims stay consistent with plan terms, cutting overrides and callbacks. ## Audit-Friendly History One timeline shows changes to codes, quantities, prices, approvals, and adjustments—linked to submission and payment events. Reviews are faster, disputes shrink, and compliance has the context it needs. Integrations ## **Connect Billing** to the Systems You Use Manage keeps your clinic’s finances running smoothly. Manage connects with QuickBooks, Avalara, PayJunction, and Waystar to simplify your clinic’s financial workflows. From invoices and tax reporting to payments and insurance reimbursements, these integrations ensure accuracy and compliance with less manual work. ![Finance Integrations Manage](https://www.auditdata.com/media/tmmaa2xu/finance-integrations-manage.gif) ## **Practice Management Software Designed for Hearing Clinics the USA** Keep secure records of your patients, implement paperless protocols, ensure consistent data, and use insights gathered from across the hearing care journey to deliver the best care experience. **Frequently Asked Questions** ## Do you support CMS-1500 with ICD-10/CPT? Yes. Claims use CMS-1500 with ICD-10/CPT and required fields to reduce denials. ## Can we submit claims electronically (eClaims)? Yes—send via your clearinghouse (e.g., Waystar) and receive status updates sooner. ## Do you support bulk insurer payment posting in the US? No. The US uses payment application tools (no bulk posting). ## How do you keep payer vs. patient balances accurate? We post at line level with adjustments and notes, then mirror results to finance via accounting sync and ERP/CRM. ## How are refunds, discounts, and tax handled? Permissioned workflows with automatic recalculation. In the US, Avalara can validate tax rates and addresses in real time. ## How do we reconcile with accounting (QuickBooks)? Use accounting export for journals/daily totals or journal export (IIF/CSV) for QuickBooks Desktop/Online. ## Do you support institutional (UB-04) claims? This page focuses on CMS-1500 professional claims typical for hearing care. If you have a UB-04 need, we’ll scope it. ## Is online patient payment part of this page? No—online/text-to-pay is not part of standard insurance workflows here. See[Billing & Payments](https://www.auditdata.com/features/billing-and-payments/ "Billing and Payments") for card-present checkout at the counter. ## What data and compliance controls apply? Audit trails on claims and postings, HIPAA/GDPR-aware processes, and PCI-compliant payment providers (for card flows referenced on the Billing page).