Generating A Claim
Written by David Mamae
Updated at March 6th, 2025
Table of Contents
Generating a Claim
Generating a claim in Pear Suite ensures that billable activities are documented correctly for reimbursement. Claims are automatically created when a billable activity is completed, as long as all required details are entered.
What is an Activity?
An activity is a recorded interaction or service provided to a member. Activities can be started from the Dashboard or the Member’s Page and may include services such as assessments, care coordination, or follow-ups.
What Makes an Activity Billable?
Not all activities are billable. To submit a claim, an activity must be Marked As Billable when it is completed.
When finishing an activity:
- Click Finish to open the End Activity window.
- Select the Mark as Billable checkbox.
- The Claim Details section will appear, requiring key information.
Mark an Activity as Billable
Claim Details In An Activity
When an Activity is Marked as Billable, the Claim Details section appears. All four fields in this section are required, as shown by the red asterisk (*). These fields ensure that the Claim has all the necessary details for processing:
- Insurance: The insurance provider linked to the Claim.
- Procedure and Modifiers: The correct Procedure Code and Modifiers for the service provided.
- Diagnosis: The diagnosis codes associated with the Claim.
- Place of Service: The location where the service was provided.
Completing Claim Details
Important Note
Once a claim has been submitted, the Claim Details section can no longer be edited or changed. It is important to review all details carefully before submitting to avoid errors or delays in processing.
Ensuring all required fields are entered correctly before finalizing the activity helps prevent errors and delays in claim processing.