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We are currently updating the OP Help Center content for the release of OP 20. OP 20 (official version 20.0.x) is the certified, 2015 Edition, version of the Office Practicum software. This is displayed in your software (Help tab > About) and in the Help Center tab labeled Version 20.0. We appreciate your patience as we continue to update all of our content.

Viewing a Patient's Claims

Version 14.19

Overview

To review a Claim for charge and payment history:

Viewing Patient's Claims

  1. Click the Patient Chart button on the Clinical, Billing, or Practice Management tab.
  2. Search for and select the Patient, if needed.
  3. Click Claims in the Account section of the Window Navigation Panel.
  • Claims are listed in chronological order with the most recent date of service at the top. To reorder the dates of service, click the Claim # column header to bring the oldest date to the top.
  1. Click the plus sign next to the claim number to expand the Claim and view the details for an individual Claim. To view details for all claims, select the Expand All checkbox. Click the minus sign can the be used to compress the claim details.
  • Charge lines are displayed in yellow.
  • Patient transactions are displayed in pink.
  • Insurance transactions are displayed in green.
  • Select the Include Voids checkbox to see any voided claim lines.  
  1. Claims can be viewed in different ways:
  • By Status: 
  • All - displays all of the patient's claims regardless of the status,.
  • Due - lists claims with either an insurance balance, patient balance, or both. 
  • Prf? - claims where the sum of payments and adjustments does not equal the total applied against a particular CPT code.
  • By Date Range: default is All, but can choose:
  • < 30
  • 31-60
  • 61-90
  • >90

Viewing Further Details of Claim Lines

To view further details of a Claim, Payment, or Adjustment line, double-click the line.

  • Double-click a Charge line. The Claim Details: Linked Charge Transactions window is displayed where you can view more detailed claim information. View the image below to see all of the information included in this detail.

  • Double-clicking a payment line (patient or insurance) will open the Claim Details: Linked Payment Transactions window. View the image below to see all of the information included in this detail.

  • Double-click an Adjustment line (patient or insurance). The Claim Details: Linked Payment Transactions window is displayed. View the image below to see all of the information included in this detail.

  • If there is a Patient Responsibility, click it for further details.
Version 14.10

Overview

To review a Claim for charge and payment history. 

Viewing Patient's Claims

  1. Click the Account button to open the Patient Account.
  2. If needed, use the Search box to locate the patient.
  3. Click the Claims tab.
  • Claims are listed in chronological order with the most recent date of service at the top. To reorder the dates of service, click the Claim/Pay Date column header to order by oldest date.

  1. Click the Plus sign next to a Claim Number to view the details for an individual Claim. To view details for all Claims, select the Expand All checkbox. Click the minus sign to hide the claim details.

  • Charge lines are displayed in yellow.
  • Patient transactions are displayed in pink.
  • Insurance transactions are displayed in green.
  • Select the Include Voids checkbox to view any voided claim lines.  
  1. Claims can be viewed in different ways:
  • By Status: 
  • All - displays all of the patient's claims regardless of the status,.
  • Due - lists claims with either an insurance balance, patient balance, or both. 
  • Prf? - claims where the sum of payments and adjustments does not equal the total applied against a particular CPT code.

  • By Date Range: from All to claims older than 90 days.

Viewing Further Details of Claim Lines

To view further details of a Claim, Payment, or Adjustment line, double-click the line.

  • Double-click a Claim line to display the Claim Details: Linked Charge Transactions window. View the image below to see all of the information included in this detail.

  • Double-click a Payment line (patient or insurance) to open the Claim Details: Linked Payment Transactions window. View the image below to see all of the information included in this detail.

  • Double-click an Adjustment line (patient or insurance) to open the Claim Details: Linked Payment Transactions window. The details are the same as the window displayed above.