Practice Better insurance billing: what Claim.MD automates, and what stays yours
By Javier Alvarez · Updated · 5 min read
| Clearinghouse | Claim.MD only; you open and pay for your own account |
|---|---|
| Plans with Claim.MD | Starter $35/mo and up (billed monthly); not on the free Sprout plan |
| Inside Practice Better | Eligibility, claim submission, status, rejections, ERAs, client balances |
| Still manual | Codes and units per visit, marking claims ready, fixing rejections, reading denials, updating client balances |
| Claim sync | About every 12 hours, or by hand once an hour |
| Duo Practice on top | One-way import of clients and insurance; claims drafted for you to approve; 3.9% of what the insurer pays |
| Checked | October 13, 2026, on Practice Better's pricing page and help center |
Disclosure: Duo Practice runs insurance billing on top of Practice Better, and we wrote this page. Everything about Practice Better comes from its own pricing page and help center, checked October 13, 2026. Screens and plans change, so treat their docs as the source of truth.
Practice Better plus Claim.MD is the stack you hear about most in dietitian groups, and it earns that. The integration is real: eligibility, submission, status, rejections and ERAs all live next to the session that produced the claim. The useful question isn't whether it "does insurance". It's which steps still land on you, and how many hours that is at your volume. The step map above answers both: switch between the two setups, then put in your own volume.
How Practice Better bills insurance
- Open your own Claim.MD account and complete payer enrollment there. Practice Better's help center notes that each practitioner finishes provider enrollment with Claim.MD before submitting, and that can take days to weeks. How that account works is on our Claim.MD page.
- Link it to Practice Better on a paid plan. Claim.MD is the only integrated clearinghouse.
- Set codes on your services. Each service carries its procedure code and billing units; diagnoses come from the session note.
- Create the claim from the client record, the calendar or a booking. It starts as Draft. You complete it, mark it Ready to submit, then submit one claim or many.
- Watch it come back. Claims sync about every 12 hours (or by hand, once an hour). Paid claims show the ERA; rejected ones need correcting and resubmitting.
- Collect the client's share. The Client Responsibility column fills from the ERA; you create and send the invoice, then update the balance once the client pays.
Two details from Practice Better's own docs worth knowing before you rely on them: Denied is a catch-all for any claim the insurer paid $0 on, deductibles included, so you read each ERA for the real reason. And the secondary-insurance option adds coordination of benefits to the primary claim; it doesn't send a separate claim to the secondary payer.
Which steps stay manual
The map at the top counts time differently in one place only: the note, codes and claim, where we have a measurement (6:35 a visit in Practice Better with its AI summary vs 1:56 in Duo, from one recorded 37-minute visit; your times will differ). Benefits calls and returned claims get the same minutes on both sides. What the Practice Better column says, task by task (carried over from our earlier breakdown and re-checked against Practice Better's help center):
| Task | Practice Better + Claim.MD | With Duo Practice on top |
|---|---|---|
| Electronic eligibility check | Automatic, from the client record | Automatic, through your Claim.MD account |
| Nutrition visit limits and coverage call | You | You |
| CPT code (97802 vs 97803) and units | You, from the service setup; edit when the visit length differs | Duo, from the recorded minutes; you review |
| ICD-10 codes and pointers | From your note; you check them | Duo, from the note; you review |
| Build, mark ready and submit | You | Duo drafts and checks; you approve and press Submit |
| Status and ERA | Synced about every 12 hours | Read from your Claim.MD account; payment matched to the claim |
| Rejections | You correct and resubmit | Duo explains why; you fix and resubmit |
| Denials and appeals | You | You (Duo explains the codes; it doesn't file appeals) |
| Client balance | You invoice and update it | You, with invoices through your own Stripe account |
The pattern: Practice Better automates the transmission in the middle. The judgment before the claim (codes, units, diagnoses) and after it (rejections, denials, balances) stays with you. If you want the codes side in depth, see CPT 97802 vs 97803 and the MNT units calculator; for what comes back, the denial code reference and how to read an ERA.
Where Practice Better wins
- One place for the client relationship. Portal, programs, food journals, forms and messaging, with the claim next to the session.
- A real, maintained integration. Eligibility, submission, rejections and ERAs inside the app, plus bulk submission.
- Control. You touch every claim. If you know MNT billing cold, that is a feature.
- Price at low volume. The integration comes with any paid plan; Claim.MD is billed separately, from $30 a month.
Stay put if insurance is a modest share of your visits, your payer mix is stable and the hours in the step map don't bother you. That setup works, and nobody, including us, should talk you out of it.
When it's worth adding Duo Practice on top
The manual part grows with volume. More visits mean more claims to build and check; more new clients mean more coverage calls. When the evenings go to claims, there are two ways out: switch platforms, or keep Practice Better and hand the billing work to something built for it. Our Practice Better alternatives page covers switching, with a side-by-side recording of one visit in both apps.
Keeping it looks like this. You paste your Practice Better API keys into Duo Practice; your clients and their insurance come over, and nothing is written back. Duo records the visit, writes the MNT note and drafts the claim with codes and units from the session. You approve it, and it goes out under your NPI through your own Claim.MD account. Duo reads the ERA and explains any denial in plain English. That is insurance billing on autopilot, with you approving each claim. It costs 3.9% of what the insurer pays, with no monthly fee, and a claim paid $0 costs $0. Across two practices since May 2026, that work has meant 333 paid claims and about $42,000 collected.
What Duo Practice doesn't do: prior authorizations, appeals or credentialing. Those stay with you or a billing service. The full picture of the service is on our dietitian billing service page, and the whole process, start to finish, is in the dietitian insurance billing guide.
Common gotchas with Practice Better + Claim.MD
- Claims sent straight from Claim.MD don't sync back to Practice Better, and neither do ERAs from before you linked the account.
- Transmit approval. Practice Better recommends turning off "Transmit Approval Required" in Claim.MD so valid claims go out right away. Leave it on and claims wait for approval in Claim.MD.
- External payments overwrite ERA payments on that claim when you record them by hand.
- Invoices aren't sent automatically. A client balance becomes an invoice only when you send it, and the balance updates only when you change it.
- Timely filing doesn't wait. A rejected claim that sits in Draft is still aging; check your payers' limits with the timely filing calculator.
Practice Better and Claim.MD are trademarks of their respective owners, named here only to describe what Duo Practice works with. Neither sponsors or endorses Duo Practice.