---
title: "Insurance Guide Part 4: Submit and track insurance claims in Pabau"
description: Validate a pre-filled CMS-1500, send it to Claim.MD, track it through the nine claim folders, fix rejections and submit claims in batches.
---

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# Insurance Guide Part 4: Submit and track insurance claims in Pabau

## In this article, you will learn how to review a pre-filled CMS-1500, validate it with Claim.MD, submit the claim electronically, and track it through to remittance.

You've set up your insurance essentials (Part 1), added your client's policy (Part 2), and connected the visit to their payer (Part 3). This final part turns that finished visit into a clean electronic claim: validated before it leaves Pabau, submitted through the Claim.MD clearinghouse, and tracked all the way to payment.

**NOTE:** Insurance billing is available for practices in the United States. Claims go to payers electronically through the Claim.MD clearinghouse, using your own Claim.MD account.

**Step 1: Open the Claim From the Visit**

Every invoice issued to an insurer appears on the claims dashboard automatically. There is nothing extra to create.

1. Go to **More → Claims**. Find the visit: each row shows the date, invoice number, client and member ID, provider, insurer, the authorization code from the visit's case, the procedure and diagnosis codes, and the amounts.
2. Click **View** on the row to open the claim.

![The Insurance claims dashboard with a claim row and its View button marked](https://support.pabau.com/hubfs/Pabau%202%20Knowledge%20Base/kb/obc-2026/444163369161-01-claims-list.png)

*More → Claims lists every invoice issued to an insurer*

**Step 2: Review the Pre-filled CMS-1500**

The claim screen is the full CMS-1500, split into sections you open one at a time. Each section names the boxes it fills, and everything you set up earlier arrives pre-filled:

- **Patient** (boxes 2–5): name, date of birth, sex and address from the client record. Blank fields fall back to the client record.
- **Insurance** (boxes 1a, 4, 7, 11): the member ID and group number from the client's policy. The payer comes from the insurer link in Setup.
- **Providers** (box 24J): the practitioner who saw the client, when they have an NPI under **Setup → Claims → Claim.MD → Providers**. If they don't, the claim tells you so and you can pick another provider.
- **Diagnoses** (box 21): the client's active problems fill the ICD-10 slots, labelled A to L.
- **Claim details** (boxes 10, 12, 13, 22, 23, 27): the prior authorization number (box 23) comes from the case attached at booking.
- **Charge lines** (box 24): one line per invoice item, with the CPT/HCPCS code, units and place of service set on the service in Part 1.

![A charge line showing procedure code, modifiers, units, charge, place of service and dates of service](https://support.pabau.com/hubfs/Pabau%202%20Knowledge%20Base/kb/obc-2026/444163369161-03-charge-line.png)

*A charge line, pre-filled from the service*

You can edit anything before you send. The **Search** buttons beside the diagnosis and procedure fields open the full ICD-10-CM and CPT/HCPCS libraries.

**Step 3: Validate With Claim.MD**

1. Click **Validate with Claim.MD**. Pabau checks the required fields, then builds the exact claim Claim.MD will receive and confirms it passes. Anything wrong is shown on the field that caused it.
2. When the panel reads **No outstanding errors**, the claim is ready to send. On the dashboard it moves to **Unsubmitted**.

![The claim header with the Validate with Claim.MD and Send Invoice to Claim.MD buttons marked](https://support.pabau.com/hubfs/Pabau%202%20Knowledge%20Base/kb/obc-2026/444163369161-02-claim-workspace.png)

*Validate first, then send*

**NOTE:** If the invoice changes after you validate (a line added, removed, re-priced or re-dated), Pabau rebuilds the claim from the invoice and asks you to check it and validate again.

**Step 4: Submit the Claim Electronically**

Click **Send Invoice to Claim.MD** (the same button sits in the bar at the bottom of the screen). The claim uploads to the clearinghouse, gets a Claim.MD reference and goes on to the payer. Resubmitting the same claim later, after a correction, updates the original at the clearinghouse. It never creates a duplicate.

**TIP:** Need to send a chart note or another PDF with the claim? Click **Attach Document** in the bottom bar before you send. See [Creating a US Professional (CMS 1500) Claim](https://support.pabau.com/en/pabau2/creating-a-us-professional-cms-1500-claim?hsLang=en).

**Step 5: Track Claim Statuses**

Pabau sorts every claim into one of nine folders. They are the tiles across the top of **More → Claims**: each shows a count and the amount still owed, and clicking one filters the list. Hover the **i** on a tile for a reminder of what it holds.

| Folder | What it means |
| --- | --- |
| **Draft** | Started but not validated yet, so it cannot be sent. Check the claim and validate it. |
| **Unsubmitted** | Validated and ready to go. It just has not been sent to Claim.MD yet. |
| **Submitted** | With Claim.MD or the payer, waiting on their response. Nothing to do yet. |
| **Response received** | The payer has answered, but the money is not posted to the invoice yet. This is your posting queue. |
| **Approved** | Paid in full and reconciled. Nothing left to collect. |
| **On hold** | Parked: Claim.MD is waiting for a document the claim declares, or you parked the claim yourself while you wait on information or a decision. |
| **Rejected** | Bounced back before the payer assessed it, usually because of data such as eligibility, codes or format. Fix it and resubmit. |
| **Denied** | The payer assessed it and refused to pay. Appeal it or bill the client, because resubmitting it unchanged will not work. |
| **Partially paid** | Some money has come in and a balance is left. Check the remittance for the shortfall. |

Click **Refresh** on the dashboard to pull the latest statuses from Claim.MD. To follow one claim:

1. Open it from the list. A sent claim opens on its activity rather than the form.
2. **Submissions & Acknowledgements** lists each step with its time: validated, submitted, received by the clearinghouse, acknowledged by the payer. Click **View messages** to read what came back.
3. **Claim summary** shows the claim's status beside the invoice's payment status, and the amounts billed, recorded and outstanding.
4. Click the clock icon in the header to open the claim's full history.

![A submitted claim showing the Submissions and Acknowledgements timeline, the Claim summary and the history icon](https://support.pabau.com/hubfs/Pabau%202%20Knowledge%20Base/kb/obc-2026/444163369161-04-submitted-claim.png)

*A submitted claim opens on its activity*

**Step 6: Fix a Rejected Claim**

If Claim.MD or the payer rejects the claim, the claim moves to **Rejected** and the reasons come back onto it.

1. Click **View messages** under the rejection to read each error.
2. Not sure what to change? Click **Analyze with AI** for a plain-English explanation of the likely fix.
3. Click **Correct claim**. The claim form opens again; fix the fields the messages name, then **Validate** and **Send Invoice to Claim.MD**. The resubmission updates the same claim.

![A rejected claim with View messages, Analyze with AI and Correct claim marked](https://support.pabau.com/hubfs/Pabau%202%20Knowledge%20Base/kb/obc-2026/444163369161-05-rejected-claim.png)

*Read the messages, then correct and resend*

**NOTE:** **Analyze with AI** sends only the claim's codes and the error messages. The client's name, date of birth, address and member number are never sent.

**Submitting Several Claims at Once**

When a batch of visits is ready to bill, you don't have to open each claim:

1. On **More → Claims**, tick the claims you want to send. The checkbox at the top of the column selects every sendable claim on the page.
2. A bar shows how many are selected. Click **Submit selected**. Pabau validates each claim, sends the ones that pass as one batch, and reports how many went and how many need attention.

![Two claims ticked on the dashboard and the Submit selected button marked](https://support.pabau.com/hubfs/Pabau%202%20Knowledge%20Base/kb/obc-2026/444163369161-06-batch-submit.png)

*Send several claims in one go*

A claim that fails validation is left out of the batch with its reason listed, rather than stopping the others. Claims that cannot be batched have their checkbox greyed out.

**IMPORTANT:** Batch send covers claims that have not been sent yet. A claim you have already sent and corrected is resubmitted from the claim screen, where your edits are kept. A batch takes up to 50 claims.

**What About Payments?**

When the payer settles, its electronic remittance (ERA) arrives on the **Remittance** tab beside **Claims** (**Money → Remittance**). Pull it in, match it to the invoices and post it; the claim moves to **Approved**, or **Partially paid** if a balance is left. For a payer that pays on paper, open the submitted claim and click **Record payer payment** to enter the EOB; the claim shows as **Response received** until you post the money to the invoice. Co-pays stay on the client's side of the ledger.

**What's Next?**

That's the full cycle, from a booked visit to a paid claim. The complete Insurance Guide series:

- [Part 1: Set up the insurance essentials](https://support.pabau.com/en/pabau2/insurance-guide-part-1-set-up-the-insurance-essentials-in-pabau?hsLang=en)
- [Part 2: Client insurance setup](https://support.pabau.com/en/pabau2/insurance-guide-part-2-client-insurance-setup-in-pabau?hsLang=en)
- [Part 3: Connect appointments to insurance](https://support.pabau.com/en/pabau2/insurance-guide-part-3-connect-appointments-to-insurance-in-pabau?hsLang=en)
- Part 4: Submit and track insurance claims (this article)

Then go further with [Tracking electronic claim submissions](https://support.pabau.com/en/pabau2/tracking-electronic-claim-submissions?hsLang=en), [Submitting secondary claims in Pabau](https://support.pabau.com/en/pabau2/submitting-secondary-claims-in-pabau?hsLang=en) and [Box 23 – Prior Authorization Number](https://support.pabau.com/en/pabau2/box-23-prior-authorization-number?hsLang=en).

Questions? Reach us any time via the in-app chat. We're happy to help you get your first claims out the door.

---

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