The system automatically created and submits claim items all finalized chart items that have not been billed depending on how your organization is configured. By default this process happens every Monday night at 11:15 PM, but it is very common to run the billing process every night at 11:15 PM. During this process the system also reevaluates all the claim items that have been posted but are not yet final to see if any further action needs to be taken on them. You can force this process to happen at any time by selecting "Claim Items" and then clicking the "Process" button under Settings -> Organization.