The Different Claims+AR Stages

Version 14.8

The Different Claims+AR Stages 

 StageMeaning of StageWhen you would use this stageWhat categories are in this stage? (ex: A0-A2? or Q0-Q3?)
Urgent Problems- Still in Q0 status (never sent or printed) after two weeks
- Still in Q2 status (never acknowledged by clearinghouse after two weeks
- Still in A1/A2 status (acknowledged but never paid) after two weeks
- Rejected or denied at any time (A3,A4,A6,A7,A8,F2)
To work claims sitting with no action taken (like if a Q0 claim was daysheeted and not sent, and has an insurance balance)Various, see lists in second column
All Daysheeted claims (A/R)All archived claimsWhen working your A/RCould be any category
Not Daysheeted, new claims onlyClaims that are not archived on a daysheetWhen queueing your claims to the claims queueCould be any category
Not Daysheeted, include paymentsClaims that are not archived on a daysheet, including those with only current paymentsTo check for current payments on current chargesCould be any category
Unsent (not transmitted or printed)Claims that are not dropped to a CMS-1500 or sent electronically to the clearinghouse.To see what claims still need to be processed to CHQ0
In transmission queueClaims that are sent to Claims Queue to be printed or transmitted electronicallyTo see that claims are ready to be printed to paper or sent electronicallyQ1
Transmitted, not yet acknowledgedClaims that are sent from Claims Queue with a Q2 statusTo see what claims are not acknowledged from CHQ2
Printed (claim or statement)Claims that are printed from the claims queue or printed from the patient accountTo see what claims are printedQ3
Acknowledged by clearinghouseClaims that received an acknowledgement file back from ClearinghouseTo see what claims are acknowledged from CHA0,A1
Acknowledged by payerClaims that received an acknowledgement file back from Insurance PayerTo see what claims are acknowledged from Insurance PayerA2,A5
Denied or RejectedClaims that are rejected internally in OP and not transmitted or claims that were rejected from Clearinghouse
To see what claims are rejected or denied internally or externallyA3,A4,A6,A7,A8,F2
PendedClaims that are pending at the PayerTo see what claims are pending at the insurance levelP0-P6,R0-R16
Finalized/PaidClaims that are finalized at payer, or paid in Office Practicum
To see what claims are finalized and or paidF0,F1,F3,F3F,F3N,F4
UncollectableThis is used to track the uncollectable balances for patients that are in bad debtto track the total balances sent to an U/C status and potentially use this to send to a collection agency.FU