What it is
Normally, someone on the billing team opens a client's billing period, looks it over, Automatic Claim Submission can submit eligible insurance claims for you without requiring a billing team member to manually open the billing period and click Submit.
The feature is designed to submit claims only when all required checks pass. If a claim needs review or a decision from your billing team, Careswitch leaves it open for staff to handle manually.
Before You Start
Automatic Claim Submission:
Is turned on for your agency by Careswitch staff.
Requires your agency to be set up for electronic billing, including a connected billing provider and approved payer enrollment.
Applies only to insurance and third-party payer claims. Private-pay invoices and other billing types are not affected.
When Claims Are Submitted
Automatic Claim Submission waits until 24 hours after a billing period ends before checking whether the claim is ready to submit. This gives your team time to finish documentation, make corrections, or update shifts.
A billing period is eligible for automatic submission only while it is between 24 and 72 hours after it ends.
After 72 hours, the claim will no longer be considered for automatic submission and must be submitted manually.
This means:
Billing period ends → 24-hour waiting period → Automatic submission window → 72-hour cutoff
What Makes a Claim Eligible?
Before submitting a claim, Careswitch checks the same requirements that apply when you manually click Submit.
For example, the claim must have:
Claim line items, payer configuration, and a valid claim number.
Required client information, such as date of birth and diagnosis codes.
Complete billing provider information, including name, address, tax information, and contact information.
Required EVV information for every visit included on the claim.
A payer that accepts electronic claims from your agency, with enrollment approved.
All shifts in the billing period must be included
Every shift in the billing period must be on the claim.
If even one shift has not been billed, Careswitch will not automatically submit the claim. Your billing team can still choose to submit a partial period manually when appropriate.
The claim cannot exceed an authorization limit
If submitting the claim would cause the client to exceed their authorized hours or units, Careswitch will not automatically submit it.
Your billing team can review the situation and decide how to proceed.
If any required check fails, the billing period is simply skipped. It remains open and editable for your team to review and submit manually.
What Automatic Claim Submission Will Not Do
Automatic Claim Submission is intentionally limited to first-time, clean claim submissions.
It will not:
Resubmit or correct a claim. Corrected claims, replacements, and voids must be submitted manually.
Retry a failed submission. If the payer or clearinghouse rejects a submission attempt, automatic submission will not try again. Your team can resolve the issue and submit the claim manually.
Submit a billing period that has already had a submission attempt. This includes attempts that failed or were dismissed from the screen. Dismissing an error does not make the claim eligible for automatic submission again.
Submit a claim twice. If a staff member manually submits a claim at the same time automatic submission is processing it, Careswitch prevents a duplicate submission.
After a Claim Is Automatically Submitted
Once a claim is submitted, it is handled the same way as a manually submitted claim.
In the activity feed, you'll see a message similar to:
Claim auto-submitted to [payer] for __ units for total charge $___
The activity identifies the claim as automatically submitted rather than listing a staff member as the person who submitted it.
From there, the claim follows the normal billing process. Acknowledgements, rejections, and remittances are handled the same way as manually submitted claims.
If the payer rejects the claim, users with billing access receive the usual notification with the reason for the rejection.
Important Things to Know
Skipped claims do not generate a notification
If a claim doesn't meet the requirements for automatic submission, Careswitch simply leaves the billing period open.
You won't receive a notification explaining why the claim was skipped. Your billing team should continue reviewing open billing periods rather than assuming that every eligible period will be submitted automatically.
Turning on the feature does not submit older billing periods
Automatic Claim Submission only considers billing periods that ended within the eligible 24–72 hour window.
Older open periods are not automatically submitted. They must be handled manually.
Fixing a failed submission does not restart automatic submission
If an automatic submission fails, that billing period is no longer eligible for automatic submission—even if the underlying issue is corrected shortly afterward.
Once the issue is resolved, a staff member must submit the claim manually.
Automatic submission is intentionally stricter than manual submission
A billing team member may sometimes decide that a claim is appropriate to submit even when something requires additional judgment—for example, a partially billed period or an authorization issue.
Automatic Claim Submission will not make those decisions.
This means not every claim will be submitted automatically. The goal is to automatically submit claims only when Careswitch can confidently determine that the claim is ready to go.