Claim Followup Concerns Escalation
The healthcare claim payment workflow is a complex process – from initial claim entry through to payment. The claim follow-up process has multiple steps that each require your attention: entering a new claim, resolving claim scrubbing errors, submitting the claim to the payer electronically or by paper, researching claim rejections, and appealing denials. This document provides guidance on when and how to move a claim through the process.
Please note: while several of the steps in this workflow involved automated processes within the ProviderSuite software and at the clearinghouse and the payer, you must still monitor those claims and take action.
Read the attached document for further guidelines on claim follow-up.
Related Articles
How to Delete or Void a Claim
Deleting or Voiding a Claim Unreleased claims can be Deleted, Released claims cannot be Deleted, they can only be Voided. Released claims with payments applied cannot be Voided until those payments are reversed or removed. Deleting and Voiding are ...
Billing Applet Claim Bucket Definitions
Introduction A description of each of our claim buckets and the claim types they contain More Information Bucket Status Description For Follow-up Statements Not Going Claims for accounts with statements on hold. Also includes ...
Printing Multiple Claims from Pending Payer Paper Claims Bucket
Follow these steps to print 08/05 1500 or UB 04 forms in bulk from the PracticeAdmin Billing applet. Click the Pending Payer Paper Claims Bucket in the Today Screen to populate the list of claims that need to be printed. Click the Print button below ...
Counting Claims for Per Claim Price Plans
As someone who is on a Per Claim price plan, we wanted to clarify how claims are counted for purposes of your PracticeAdmin invoice - specifically that there is no charge for additional printed claim copies. When you enter a new claim into ...
User Guide - Billing Manager - Claims
Billing Manager Claims In this section, we will discuss entering claim information into the Billing Manager. IMPORTANT Navigation within the Billing Manager application to move from one field to the next works best by hitting Tab on the keyboard. The ...