From the practice dashboard, you can manage claims that are overdue. A claim is overdue if it was submitted 15 or more days ago and has one of the following statuses: Sent, Accepted, Pending, Printed, Unprocessable Claim, Additional Information Requested, or Paid (the payment was sent by the third party but not received by your office). A claim will also be unresolved if it was previously unresolved, a follow-up was done, and then an additional follow-up reminder was applied to the claim. Unresolved claims also include any claim with a status of Rejected (by the payer or clearinghouse).
To process an unresolved claim
How to get there
On the Home menu, under Location, click (or tap) Overview.
The location's Overview page opens.
On the Home menu, under Third-Parties, click (or tap) Unresolved Claims.
The Unresolved Claims page opens.
On the list of unresolved claims, leave the first claim selected, or click (or tap) a different claim.
Note: The unresolved claims are grouped by third-party plans, which appear as expandable and collapsible sections. You can click (or tap) a plan's button to view the corresponding claims.
The claim options become available.
Do any of the following as needed:
Click (or tap) Review/Edit to view the claim. In the Claim Detail dialogue box, make any necessary changes, and then click (or tap) Save.
Contact the third-party and/or patient.
To specify that the claim needs additional follow-up, type any Notes, and specify who to Follow up with (third party or patient) and when you want to be reminded to follow up. Then, select the Dismiss Claim check box to remove the claim from the list until the specified number of days has elapsed.
Click (or tap) Save.