Introduction
A description of each of our claim buckets and the claim types they contain
More Information
Bucket
| Status
| Description
|
For Follow-up
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| Statements Not Going
| Claims for accounts with statements on hold. Also includes accounts where pre collection cycle is completed.
|
| Neglected Svc Details
| Claim lines that have not been submitted
|
| Pending Rebill
| Claims that have been tagged for rebill that need editing
|
| On Hold
| Claims that have been placed On Hold
|
| Credit Balances
| Any claim with a credit balance on a line item
|
| EHR Imports
| Claims imported from your electronic health records system
|
| Denied Svc Details
| Denials posted, and claim line not resubmitted yet
|
| Pending
| Any claim detail that has had transactions posted to it, but has not yet been resubmitted to a new debtor (when it is resubmitted, it will be removed from pending status)
|
Errors
|
|
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| EDI Claim Errors
| Claims that fail PA's EDI edits when claim file is created
|
| EDI Rejections
| Claims that have been rejected by Payer
|
| Pmt Processing Errors
| Payment could not process due to error. Open payment application and click "unposted button"
|
| Import Errors
| Claims with import errors
|
| Processing Errors
| Claims with errors
|
| Concurrency Errors
| Anesthesia claims that exceed concurrency limits
|
| Show All
| Shows all statuses for the Error bucket
|
Awaiting release
|
|
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| Pre-Released
| Claims with incomplete information, or claims that the user does not want to submit immediately
|
| For Review
| Claims that are ready for review
|
| Concurrency
| Anesthesia claims that require concurrency processing
|
| Show All
| Shows all statuses for the Awaiting Release bucket
|
Released
|
|
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| Awaiting EDI Submission
| Claims that are waiting to be submitted by EDI
|
| Awaiting Printing
| Claims that are waiting to be printed on a HCFA form
|
| Pending Statement
| Self Pay claims, or claims transferred to the patient, where a statement has not yet gone
|
| Pending Invoice
| Industrial Account claims where an invoice has not been sent yet
|
Submitted
|
|
|
| In EDI File
| EDI file has been created, and is pending transmission.
|
| EDI File In Transit
| EDI File is being processed by the EDI servers
|
| Submitted by EDI
| EDI file has been successfully transmitted, no confirmation received from payer yet
|
| EDI File Confirmed
| Payer has confirmed that the EDI file has been received
|
| EDI Confirmed Claims
| Positive confirmation has been received from the payer system that the claim has been received and accepted for processing
|
| Medicare Crossover
| Medicare payment file shows that claim was crossed over to secondary payer
|
| Submitted by Mail
| Claims printed by user on local computer
|
| Billed to Patient
| Self Pay claims with statement sent OR
Claims transferred to patient, and statement sent
|
| Billed to Industrial
| Industrial Account claims where an invoice has been sent
|
By Patient
|
|
|
| By Patient (OS Claims)
| Shows all outstanding claims for the patient selected in the patient combo box on claim general, or the patient name selected on PA Today (which would override any patient name on the claim general form)
Changes the columns in the grid to be DOS/Claim ID/Balance/claim status/status date
|
| By Patient (All Claims)
| Shows all claims for the patient selected in the patient combo box on claim general, or the patient name selected on PA Today (which would override any patient name on the claim general form)
Changes the columns in the grid to be DOS/Claim ID/Balance/claim status/status date
|
All Claims
|
|
|
| All Outstanding
| All claims with an outstanding balance
|
| All
| All Claims
|
Processing
|
|
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| Awaiting Pmt Processing
| Payments that are waiting to be applied to the account
|
Collections
|
|
|
| Collections - O/S
| Claims transferred to collections, but not written off
|
| Collections - W/Off
| Claims transferred to collections, and written off
|
Inactive
|
|
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| Paid
| Paid claims, or any claims that have a $0 balance as a result of posted adjustments or write-offs
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| Old (Txfer/Resub/W-O)
| For claims that have been fully adjusted off via the resubmit or transfer to secondary processes
|
| Voided
| For claims that have been voided
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