Occasionally claims will get “stuck” in pending after you’ve marked them “Ready to Bill”. Causing claims to not be submitted to the clearinghouse. Claims will be held in this status if information is missing.
Claims can get stuck for the following reasons:
1. The patient’s demographics are not completely filled out in client edit info. EX: address, DOB, diagnosis.
2. Either the payer is not selected in insurance numbers or the incorrect payer is selected.
3. Billable amount is Zero.
4. The service does not match an active insurance number entry.
How to run a stuck in pending report:
In the submission report you will select the following:
1. Select “ready to bill”: yes.
2. Select “pending” status
3. Add in an end date (the date before you run the report)
4. Filter by “ready to bill date.”
You will want to run this report weekly to ensure all claims are being submitted. For any claims that come up when running this report please check items 1-4 listed above. If the information is complete or correct, please reach out to AccuPoint for assistance.
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