Insurance User Manual – UnitusTI Help Center

Check whether a client’s insurance coverage is active (eligibility).
Create professional insurance claims from session notes or calendar events .
Review, validate, and submit those claims to payers.
Track claim status, payer acknowledgments, rejections, and remittance (ERA / 835) after submission.
Enroll your center with payers for eligibility, claims, and electronic remittance.

1. How Stedi fits in

Stedi is the partner company that provides the intermediary (clearinghouse) services on the backend.

UnitusTI does not send eligibility requests or claims directly to each insurance company. When you run an eligibility check or submit a claim, UnitusTI sends the transaction to Stedi . Stedi then routes it to the correct payer (insurance company / trading partner) using standard healthcare electronic transactions:

What you do in UnitusTI

Transaction Stedi routes to the payer

Eligibility check

270 / 271

Submit a professional claim

837P

Receive claim acknowledgment / status

277CA

Receive payment / remittance

ERA / 835

You work in UnitusTI. Stedi is the backend intermediary. Payer enrollment status, catalog routing, claim control numbers, and remittance all come through Stedi.

You do not need a Stedi login for day-to-day work. Stedi remains the system of record for full enrollment history; UnitusTI shows the current enrollment status for your center.

2. Open the Insurance module

Sign in to UnitusTI and select your center.
Open the Center menu.
Choose Insurance .

The Insurance home page opens. From there you can reach Eligibility, Claims, Insurance companies, Center enrollments, and Payer rates.

The Insurance menu item appears only when the Insurance module is enabled for the center. If you do not see it, ask a center administrator to enable the module.

You can also reach claim creation from the Session Notes Dashboard (see §7).

3. Before you start

Complete this setup before the first live eligibility check or claim.

3.1 Center billing identity

The center is the billing provider on eligibility checks and claims. In Center → Center Information , confirm:

Center name
NPI (10 digits)
Tax ID
Address, phone, and email

Enrollment cannot be submitted until NPI and Tax ID are present. Claim submit will also fail if the center NPI is missing.

3.2 Client chart — payer form

Each client you bill must have a completed payer INPUT_FORM (Primary, and Secondary if you use it). Required for eligibility and claims:

Payer name and payer ID
Member ID (insurance card ID)
Insured name, date of birth, sex, and address
Relationship to insured (self, child, other)
Group number, when the plan uses one

If the member ID is missing, eligibility and claim wizards will block you until the payer form on the client chart is completed.

3.3 Client chart — diagnoses

Claims need ICD diagnosis codes from the client’s diagnosis INPUT_FORM . The claim wizard cannot continue without at least one diagnosis.

3.4 Session notes or calendar events

Session notes path: signed (or otherwise billable) notes that include service codes and units.
Calendar path: calendar events that have a service code . Events without a service code are not offered as claim lines.

3.5 Stedi payer mapping

The payer on the client chart is not always the same identifier Stedi uses to route the transaction. In the eligibility and claim wizards you confirm a Stedi payer (trading partner from Stedi’s catalog). UnitusTI tries to match automatically; you can change the match if it is wrong.

3.6 Center enrollment with Stedi

Some payers already support a transaction type without extra setup. Others require center enrollment with Stedi for:

Eligibility (270/271)
Professional claims (837P)
ERAs (835)

If a payer requires enrollment and the center is not live for that transaction, eligibility and submit are blocked until enrollment is complete. See §11.

3.7 Payer rates (fee schedule)

Claim line charges come from Payer rates , not from Simple Invoicing / billing concepts.

Formula: charge = units × rate per unit for that Stedi payer and service code.

You can set rates in Payer rates , or inline in a claim wizard with Set rate . You cannot create a claim until every included line has a rate.

4. Home

The Insurance home page is titled Insurance .

Insurance Claims Summary

Clickable chips show counts for:

All claims
Needs action (rejected or error)
Each status: Draft, Ready, Submitted, Accepted, Paid, Rejected, Error, Archived

Click a chip to open the claims list already filtered.

Area cards

Card

What it opens

Eligibility

Verify coverage and benefits with payers before scheduling or billing.

Claims

Create, review, and submit claims from session notes and calendar data.

Insurance companies

Stedi trading-partner catalog for eligibility and claims routing.

Center enrollments

Manage Stedi transaction enrollments for this center’s billing provider.

Payer rates

Set charge-per-unit rates by Stedi payer and service code.

5. Eligibility

Use eligibility to confirm that a client’s plan is active and to see copay, deductible, and related benefits before you schedule or bill.

Stedi sends a real-time eligibility inquiry to the payer and returns a summary in UnitusTI. The full Stedi response is stored on the server for compliance; the screen shows the parsed summary only.

5.1 History list

Open Eligibility from home.

The table lists previous checks: client, date checked, status, coverage (yes/no), copay, and Stedi payer. Filter by client name. Click a row to open the result.

Statuses you may see: Active , Inactive , Pending , Failed , Error .

5.2 Run a new check

Click New eligibility check .
Client — search and select the client.
Payer — choose the payer INPUT_FORM execution (Primary / Secondary). Confirm member ID, group number, and subscriber. Confirm or change the Stedi payer . The helper text is: Trading partner from the Stedi payer catalog used for eligibility and claims.
Check — set the date of service (the date used when querying payer eligibility) and run the check.
Result — review coverage, copay, deductible, deductible remaining, out-of-pocket max, coinsurance, plan dates, and benefit lines. Click Done .

5.3 Eligibility blockers

You cannot continue until these are resolved:

Message

What to do

Select a client to continue.

Pick a client.

No payer information found on the client intake form.

Complete the payer INPUT_FORM on the client chart.

Member ID is required on the selected payer.

Add the member ID on the payer form.

Select a Stedi payer to continue.

Choose a Stedi trading partner.

This payer is not enrolled for eligibility checks.

Complete Center enrollments for Eligibility (270/271).

This payer does not support this transaction type in Stedi.

Choose a different Stedi payer.

Provider NPI is missing.

Add the center NPI in Center Information.

6. Claims list

Open Claims from home or from a summary chip.

Create a claim

Use the actions menu:

Create from Session Notes — confirms that claims from session notes are created from the Session Notes Dashboard Export option, then redirects you there. Continue with §7.
Create from Calendar — opens the calendar wizard. Continue with §8.

Tabs

All claims — full list, with optional filters.
Needs action — claims in Rejected or Error that need staff follow-up. The tab shows a count when greater than zero.

Filters

Status (disabled while Needs action is selected)
Client
Service dates
Clear filters

Refresh the list with the refresh icon. Sort by client, payer, service dates, status, total, or updated. Open a claim by clicking the client name, or select a row for list actions (submit, archive, delete when allowed).

Columns: Client, Payer, Service dates, Status, Total, Updated.

7. Create a claim from session notes

This is the primary path when you bill from documented sessions.

One claim = one client + one payer + the session notes you exported. Multiple notes become multiple service lines on a single professional claim.

7.1 Start from the Session Notes Dashboard

Open the Session Notes Dashboard .
Select exactly one client . (Selecting none or more than one shows: Select exactly one client before creating claims. )
Filter the notes you want to bill (date range, signed, etc.). Only notes with service codes are included. If none have service codes: Include session notes with service codes before creating claims.
Open Export .
Under Billing , click Create claims .

(If EZClaim is also enabled for the center, EZClaim remains available as a separate export. Create claims is the Stedi / Insurance path.)

UnitusTI stores the selected notes and opens Insurance at New claim .

If you land on Missing or expired claim request , start again from Session Notes Export. The request is temporary and lives in the browser session.

7.2 Wizard steps

Step 1 — Review notes

Confirms the client and lists the exported session notes: date/time, users, service codes with units, and a short text preview.

A warning icon on a note means those notes are already used in another claim . Hover to see claim numbers and statuses. You can still continue, but double-check to avoid duplicate billing.

Click Continue .

Step 2 — Payer

Select the client’s payer (Primary / Secondary).
Review payer details: name, payer ID, member ID, group number, subscriber.
Confirm the billing provider (center name and NPI).
Confirm or change the Stedi payer . A chip or alert tells you whether this payer is ready to bill . If enrollment is required and not live, finish Center enrollments before you will be able to submit later.

You cannot continue without a payer, a member ID, and a Stedi payer.

Step 3 — Lines

Each service code on each selected note becomes a line:

Include / exclude (checkbox)
Date, procedure, units
Rate / unit and line Charge (units × rate)
Diagnosis pointers (which diagnosis numbers apply to this line)

If a rate is missing, a warning appears: One or more lines need a payer rate before you can continue. Use Set rate to add the charge per unit. Click Set rate , enter the charge per unit for that Stedi payer and service code, and save. The rate is stored on the fee schedule and reused on later claims.

If no diagnoses exist: No diagnoses found for this client. Complete the diagnosis form on the client chart.

Default diagnosis pointers include all listed diagnoses; adjust per line as needed.

Step 4 — Confirm

Review client, session note count, payer (including Stedi payer), service dates, included line count, and total. Included lines are listed with procedure, units, charge, and diagnosis pointers.

Info note: The claim will be saved as a draft. You can edit lines and submit from the claims list.

Click Create claim .

7.3 After create

Success shows the new claim id. Open Claim detail to validate and submit, or return to Claims .

Creating a claim does not send it to the payer. Submission is a separate step (§9).

8. Create a claim from calendar events

Use this when you bill from scheduled calendar events that have service codes, rather than from session notes.

Open Claims → actions menu → Create from Calendar . Title: New claim from calendar .

Step 1 — Client

Select the client whose calendar events will be billed on this claim. Search and pick the client, then Continue .

Step 2 — Events

Click the search (dates) control and choose From / To .
Click Search events .
Only events with a service code are listed. If none: No calendar events with a service code were found for this client and date range.
Optionally filter by Service code .
Check the events to include (all matching events are selected by default). Use the header checkbox to select or clear the current page.

A warning icon means the event is already used on another claim.

Units are calculated from event duration when the service code unit type is time-based (minutes). Otherwise the default is 1 unit. You can edit units on the preview step.

You must select at least one event to continue.

Step 3 — Payer

Same as the session-notes wizard: client payer form, center as billing provider, Stedi payer from Stedi’s catalog, enrollment / billability warning.

Step 4 — Preview

Review lines (date, procedure, units, rate, charge, diagnosis pointers). Set missing rates with Set rate . Adjust units and diagnosis pointers.

Click Create claim . The claim is saved as a draft. Open claim detail to submit.

9. Claim detail: edit, validate, and submit

Open a claim from the list or after create. Header shows client, Stedi payer, service dates, total, and status.

After submit, Stedi identifiers may appear:

Stedi control number
Stedi transaction ID
Payer claim reference

9.1 What you can do, by status

Status

Meaning

Typical actions

Draft

Created, not marked ready

Edit lines, Mark ready, Validate, Submit, Archive, Delete

Ready

Ready to send

Edit lines, Validate, Submit, Archive, Delete

Submitted

Sent to Stedi for the payer

Refresh status

Accepted

Payer acknowledged

Refresh status; wait for remittance

Rejected

Payer or Stedi rejected

Edit to resubmit, then Validate and Submit

Paid

ERA / 835 applied

Review remittance

Error

Processing error

Fix data; resubmit if allowed

Archived

Hidden from the default list

—

Needs action on the claims list is Rejected and Error .

9.2 Edit lines (Draft / Ready)

Turn on Edit . You can change procedure, modifiers, place of service (POS), units, diagnosis pointers, and whether a line is included. At least one line must remain included.

Charge recalculates when units change if a rate per unit exists.

Save lines persists changes. Discard reverts unsaved edits. Save before Validate or Submit ( Save all line changes before submitting the claim. ).

9.3 Validate

Validate runs a pre-submit check (including Stedi claim edits) without sending the claim. Status does not change.

Success: Claim passed validation.
Issues: Validation found issues. Fix them before submitting. Fix lines or chart data and validate again.

9.4 Submit

Submit sends the professional claim (837P) through Stedi to the payer.

Confirm: Submit this claim to the payer? This cannot be undone.

After submit:

Status becomes Submitted .
The screen may show Checking for payer updates… while UnitusTI waits for Stedi / payer acknowledgments.
Use Refresh status to pull the latest 277CA (and later 835) updates.

If the payer is not enrolled for professional claims, submit is blocked until Center enrollments is complete.

9.5 Mark ready, archive, delete

Mark ready — draft → ready ( Mark this draft claim as ready to submit? ).
Archive — hides a never-submitted draft/ready claim from the default list. It is not sent.
Delete draft — permanently removes a never-submitted draft/ready claim. This cannot be undone.

You cannot archive or delete a claim that was already submitted to Stedi.

9.6 Rejected claims — resubmit

Edit to resubmit — reopens the claim as Ready and turns on edit.
Correct lines, diagnoses, or chart data (payer form, NPI, rates).
Validate , then Resubmit .

Confirm: Resubmit this corrected claim to the payer?

9.7 Remittance (835)

When Stedi delivers an ERA and it is matched to the claim, status can become Paid and a Remittance (835) card appears:

Amount paid
Billed amount
Patient responsibility
Payment date
Payment method / check or EFT trace

9.8 View log

View log opens the claim activity channel (comments and system log for that claim). Use it for collaboration and audit notes. Status changes from Stedi (acknowledged, rejected, ERA) are stored on the claim; payer messages also appear as Payer message on the detail page when present.

9.9 Patient and provider cards

Patient / subscriber — member ID, group, relation to insured, demographics from the payer form. Incomplete member ID must be fixed on the client’s Primary payer form before submit.
Provider — billing provider (center NPI) and rendering providers from the session notes or calendar events. Missing center NPI must be fixed in Center Information.

10. Payer rates

Open Payer rates from home, or Rates on an enrollment row.

Charges on claim lines use this schedule: units × rate per unit , keyed by Stedi payer and service code .

Index

Lists payers that already have rates (name, Stedi ID, rate count, last updated). Click a payer to open its table. Add rates for a payer (or Choose payer ) picks a Stedi payer from the catalog.

Payer rate table

Add rate — choose a service code and charge per unit.
Edit or delete an existing rate.
Empty: No rates for this payer yet. Add a service code rate to begin.

You can also add a rate from a claim wizard with Set rate . That writes the same fee schedule.

Rates are not taken from Simple Invoicing billing concepts. Insurance and invoicing fee lists are separate.

11. Center enrollments

Enrollment tells Stedi that this center (billing NPI + tax ID) may exchange a given transaction with a given payer.

Enrollment is per payer × transaction type , not one switch for the whole center.

Transaction types

Label in the UI

Use

Eligibility (270/271)

Real-time benefit checks

Professional claims (837P)

Submitting claims

ERAs (835)

Electronic remittance / payment posting

Worklist

Open Center enrollments .

The table shows Stedi ID, transaction type, status, and last synced.

Statuses include:

Live — you can transact.
Submitted to Stedi — request sent; waiting on Stedi / payer.
Action required — the center must complete a task (often via information Stedi emailed).
Provisioning
Draft , Rejected , Canceled

Intro text: Current enrollment status per payer and transaction type. Sync from Stedi to refresh; full history is in Stedi.

Sync from Stedi refreshes current status from Stedi. Attempt-by-attempt history stays in Stedi, not in UnitusTI.

Rates on a row opens that payer’s fee schedule.

New enrollment

Click New enrollment .
Confirm billing provider NPI and Tax ID (read from Center Information). If either is missing: Please set this value in the center configuration screen.
Choose a Stedi payer from the catalog (filters: All, Enrolled, Ready to bill).
Select the transaction type.
Enter Stedi contact email . Stedi sends enrollment status updates to this address (defaults to the center email).
Submit enrollment .

Stedi only accepts a new enrollment when the catalog says Enrollment required for that payer and transaction.

If the payer already supports the transaction without enrollment: This payer already supports this transaction without enrollment. You can use it right away—no enrollment request is needed. Do not submit.
If the payer does not support the transaction: choose a different Stedi payer.

After submit, status is typically Submitted to Stedi . Use Sync from Stedi until it becomes Live (or Action required ).

Some payers are Supported in the catalog with no enrollment. Those are billable immediately.

12. Insurance companies (Stedi catalog)

This is a read-only reference of Stedi trading partners. It is not your enrollment worklist.

Intro: Trading partners from the Stedi payer catalog. Transaction support reflects what Stedi can route—not your center enrollment status.

Search by name or ID. Filter by operating states (including National). Columns include name, Stedi ID , primary payer ID, aliases, states, and professional-claims support:

Supported — Stedi can route; no enrollment request needed.
Enrollment required — complete Center enrollments before live traffic.
Not supported — Stedi cannot route this transaction for that payer.

Use this page to confirm the correct Stedi payer ID when matching the client’s insurance to the catalog.

13. Typical production workflow

Center setup — NPI, tax ID, address; Insurance module enabled.
Enroll with Stedi for each payer you will use for eligibility, 837P claims, and (if you want ERAs) 835.
Set payer rates for those Stedi payers and your service codes.
Client chart — complete payer and diagnosis INPUT_FORMs (member ID, demographics, ICD codes).
Eligibility — check coverage before the service date when policy requires it.
Document the service (session note with service codes, or calendar event with a service code).
Create claim from session notes or calendar.
Review lines , rates, units, and diagnosis pointers.
Validate , then Submit . Stedi delivers the 837P to the payer.
Refresh status until Accepted, Rejected, or Paid. Fix and resubmit rejections. Review remittance when the 835 arrives.

14. Troubleshooting

Problem

What to try

Insurance is not in the Center menu

Ask an administrator to enable the Insurance module for the center.

No payer information found

Complete the payer INPUT_FORM on the client chart.

Member ID required

Enter the insurance member ID on that payer form.

Select a Stedi payer

Pick the trading partner from Stedi’s catalog; search by name or payer ID.

Not enrolled / not billable

Open Center enrollments; submit or sync until Live , or pick a payer that is Supported without enrollment.

Center NPI / Tax ID missing

Update Center Information, then retry enrollment or submit.

No diagnoses

Complete the diagnosis INPUT_FORM.

No billable service lines

Session notes need service codes; calendar events need a service code.

Missing rate

Set rate in the wizard or add the rate under Payer rates.

Create from Session Notes does nothing useful

You must start from Session Notes Export → Create claims with exactly one client. The Claims menu item only redirects you there.

Missing or expired claim request

Export Create claims again from Session Notes in the same browser session.

Already used in claim warning

That note or event is already on another claim. Confirm you are not double-billing.

Validation found issues

Read the validation messages; fix lines, POS, modifiers, diagnoses, or payer data.

Submit cannot be undone

Correct in UnitusTI, then use Edit to resubmit after a rejection. Do not create a duplicate claim unless billing policy requires a new claim.

Status stuck on Submitted

Click Refresh status . Acknowledgments arrive from Stedi via backend notifications (277CA).

No remittance card

ERA (835) enrollment may still be pending for that payer; or the 835 has not been matched yet.

EZClaim vs Insurance

EZClaim CSV export can remain available. Insurance / Stedi is the in-product electronic claim path. They share the same payer forms; they do not replace each other automatically.

15. Glossary

Term

Meaning in this module

Stedi

Partner company providing clearinghouse / intermediary services. UnitusTI sends eligibility and claims to Stedi; Stedi routes them to payers.

Stedi payer / trading partner

Payer as identified in Stedi’s catalog (Stedi ID), used for routing.

Payer (client chart)

Insurance recorded on the client’s payer INPUT_FORM. Mapped to a Stedi payer when you check eligibility or create a claim.

Billing provider

The treatment center (NPI / Tax ID), not the individual clinician and not UnitusTI.

Rendering provider

Clinician who performed the service (from the session note or calendar event).

Subscriber

Person enrolled in the plan (policy holder). May or may not be the client.

Member ID

ID on the insurance card. Required. Not the UnitusTI client id.

837P

Professional claim (typical behavioral / ABA professional billing).

270 / 271

Eligibility inquiry and response.

277CA

Claim acknowledgment / status from the payer via Stedi.

ERA / 835

Electronic remittance advice (payment, adjustments, patient responsibility).

Enrollment

Registering this center with a specific payer for a specific transaction through Stedi.

Supported (catalog)

Stedi can route this transaction without a new enrollment request.

Enrollment required

You must complete Center enrollments before live eligibility or claims.

Payer rates

Charge per unit by Stedi payer and service code. Source of claim line charges.

Diagnosis pointer

Which listed diagnosis number(s) apply to a service line (e.g. 1, 2).