Update Claim Status with Clearinghouse Acknowledgements

Version 14.8

Overview

If your office has a supported clearinghouse and your claim audit reports are automated through your clearinghouse.

Update Claim Status

  1. Click on the Billing button to open the e-Billing center.
  2. Click on the Claims + A/R tab .  
  3. Click on the Fetch button, then click Yes when prompted Fetch Payer Reports?. OP will go idle when the process is complete.

This action will fetch (retrieve) any unread audit reports from your clearinghouse and place them in your Administrative Documents.

  1. Click on the Process button . This action will allow OP to read any unread audit reports from your clearinghouse and updated the corresponding claim status.
  2. Click Yes when prompted Process Payer Reports?. OP will go idle when the process is complete.
  3. You will now be able to view the most recent audit report response of claim status from your clearinghouse.

You also have the option to manually add known claim status as follows:
  • Click on the claim in question (it will appear highlighted)
  • Click on the radial dial for Status history .
  • Click on Add Status Icon.
  • Click on the Pencil icon to allow edits.
  • Click on the dropdown in the status category field (below the specified claim) to select an updated or alternate status.
  • Edit the Note field if/as applicable (to provide further details of this status change).
  • Click on the green checkmark to save this status update.