Does Upheal handle insurance billing? Here's what's included
Yes, Upheal handles insurance billing. Upheal submits insurance claims, checks client eligibility, and matches payments to claims automatically, all from inside the same platform you already use for notes and scheduling. There's no monthly fee for billing. You pay $0.30 per claim submission and $0.15 per eligibility check.
What's included
Claims. Claims fill in from data already in Upheal, including secondary insurance and the Place of Service and modifiers from the session's location and payer. Submit one at a time, in a batch, or with several sessions on one claim. Correct a rejected claim and Upheal offers to fix the client record too, so the next one doesn't bounce.
Eligibility checks. Clients add their insurance through an intake form or a card photo, and you check eligibility before the session instead of finding a lapsed plan afterward.
Prior authorizations. Track each authorization's approved visits and dates, and Upheal counts visits down as claims use them. When a client switches insurers, archive the old policy and reactivate it later to finish old claims.
Payment matching (ERA). When a payer sends an electronic remittance advice, Upheal matches it to the original claim and shows expected against actual payment, so a short payment doesn't slip past you. Paper EOBs post manually, with adjustment reasons picked from a searchable list of standard payer codes.
Denials and appeals. If a claim is denied, Upheal shows the payer's reason code and drafts an appeal letter from the client's chart, so you edit a draft instead of writing one under a deadline.
Billing questions, answered in plain language. Ask Upheal Assistant about a specific claim or client instead of digging through a claims dashboard.
Insurance billing at a glance
| Feature | What it does |
|---|---|
| Claims | Autopopulates from session and client data, submit one at a time, in a batch, or with several sessions on one claim |
| Eligibility checks | Confirms coverage before the session, so a lapsed plan does not surprise you afterward |
| Prior authorizations | Tracks approved visits and dates, counted down as claims use them |
| Payment matching (ERA) | Matches incoming remittance advice to the original claim automatically |
| Denials and appeals | Shows the payer's reason code and drafts an appeal letter from the client's chart |
| AI Assistant | Answers billing questions about a specific claim or client in plain language |
What it costs
There's no monthly fee or setup cost for insurance billing. You pay per action, only when you bill:
| Action | Cost |
|---|---|
| Claim submission | $0.30 per claim, including its ERA. One claim can carry several sessions for the same client and payer. |
| Eligibility check | $0.15 per check |
What you're still responsible for
Insurance billing through Upheal doesn't replace your own payer contracts or credentialing. You still need to be paneled with the insurance companies you're billing, and you're the one who decides whether to accept a given plan. Upheal handles the submission and tracking, not the underlying business relationship with the payer.
If you run a group practice, billing profiles support multiple office locations and practices. They're not built around routing claims by supervisor, so if you need a workflow tied to supervisor sign-off, this isn't that.
Curious what insurance billing looks like end to end, from claim to payment? See how Upheal's insurance billing works.
Frequently asked questions
Does Upheal handle insurance billing?
Yes. Upheal submits claims, checks eligibility, and matches payments automatically, at $0.30 per claim and $0.15 per eligibility check.
Does Upheal charge a monthly fee for insurance billing?
No. There's no monthly fee or setup cost. You only pay per claim submitted and per eligibility check run.
Can Upheal help with denied claims?
Yes. Upheal shows the payer's denial reason and drafts an appeal letter from the client's chart, which you review before sending.
Do I need to be credentialed with insurance companies to use Upheal's billing?
Yes. Upheal submits and tracks your claims, but you still need your own payer contracts and credentialing in place.
Does Upheal support billing for group practices?
Yes. Billing profiles support multiple locations and practices, and a free Biller role handles billing without seeing clinical notes. Supervisor-based billing workflows aren't supported.
How does Upheal match insurance payments to claims?
When a payer sends an electronic remittance advice, Upheal automatically matches it to the original claim and shows expected payment against what was actually paid.
