Today Screen Dashboard Claim Buckets
| Status |
Bucket |
Description |
| Identify/Correct/Rerelease |
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Claim Line Credit Balance |
Any claim with a credit balance on a line item. You can move credits to unapplied to move to another DOS or can be moved to an open balance in the same claim. You cannot move credits to other family member’s accounts without posting the transaction again. |
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Claim Line Denied by Payer |
Denials posted, and claim line not resubmitted yet. Denials are posted during the payment posting process as Insurance Denied transaction only line. To resubmit a claim to a payer you must resubmit the claim from Claim-Final by clicking release. |
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Claim Line Unsubmitted |
Claim lines that have not been submitted to any debtor. For claims that have been split between two different debtors, make sure to release each claim line to the correct debtor.
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Claim On Hold |
Claims on hold are shown in blue in claim filter. Claims are placed and removed from Hold on the Claim-General tab. Placing a claim on hold will suspend the claim in the current claim status.
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Claim Processing Error |
Claims with errors |
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Claim Scrubbing Error |
Claims that fail internal EDI edits when the claim file is created. (See Billing Manager Claim Scrubbing Error) |
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Concurrency Error |
Anesthesia claims that exceed concurrency limits. |
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Payment Posting Error |
Payment could not process due to error. Open the payment application and click "un-posted button". |
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Pending Industrial Invoice |
Industrial Account claims where an invoice has not been sent yet. |
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Pending Patient Statement |
Self-Pay claims, or claims transferred to the patient, where a statement has not yet gone |
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Pending Payer Paper Claim |
Claims that are waiting to be printed on a HCFA form |
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Pending Rebill |
Claims that have been tagged for rebill that need editing |
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| Provider On Hold |
Claims that are on hold because the provider is on hold for an EDI Service. Contact the EDI department if you are a direct customer to help resolve this issue.
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| Rjctd by Clearinghouse/Payer |
Claims that have been rejected by the payer. |
| Statements Not Going |
Claims for accounts with statements on hold. Also includes accounts where pre-collection cycle is completed. |
| Review |
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| Concurrency Review |
Anesthesia claims that require concurrency processing |
| For Billing Approval |
Claims that are ready for review (managers can use this bucked for billing approval) |
| For Client Review |
Claims that are ready for review (billing services can use this bucket for the practice) |
| For Review |
Claims that are ready for review |
| Imported Charges |
Claims imported from your electronic health records system |
| Imported Charges Error |
Claims imported from your electronic health records system that has errors |
| Pre-Released |
Claims with incomplete information, or claims that the user does not want to submit immediately |
| Pending |
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| Awaiting Claim File Creation |
Claims that are waiting to be submitted by EDI |
| Pending Xfer to Clearinghouse |
EDI file has been created, and is pending transmission. |
| Various Stages |
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| Claim Printed for Payer |
Claims printed by user on local computer |
| In Transit to Clearinghouse |
EDI File is being processed by the EDI servers |
| Invoice Printed for Ind Acct |
Industrial Account claims where an invoice has been sent |
| Medicare Crossover |
Medicare payment file shows that claim was crossed over to secondary payer |
| Rcvd by Clearinghouse/Payer |
Payer has confirmed that the EDI file has been received |
| Sent to Clearinghouse |
EDI file has been successfully transmitted, no confirmation received from payer yet |
| Statement Printed for Pt |
Self-Pay claims with statement sent Claims transferred to patient, and statement sent |
| Under Review at Payer |
Positive confirmation has been received from the payer system that the claim has been received and accepted for processing |
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