On this page, you can view all claims that are in Claim Review status. These claims require additional review and action to ensure the accuracy of the entire claim, including patient details, encounter information, and associated charges.
To access this, click Claims > Claim Review on the left side menu.
Use the table to browse and manage claims.
Date of Service
The date on which the service was provided to the patient.Patient Name
The name of the patient who received the service.
Payer
The insurance payer responsible for payment of the claim.
Provider
The healthcare provider who performed the service.
Member ID
The insurance member ID used to identify the patient in payer systems and claims processing.
Charge
The initial, full amount billed by the provider for the service.
Assignee
The biller currently assigned to work on the claim.
Status
Displays the current status of the claim:
New
In Progress
Closed
Approved
Deferred
Resumed
Double-click onto any of the claims to enter the Claim Review Detail Page. For more information on how to navigate that page, please refer to Claim Review Detail Page.
Note: Every evening, any claim marked as Approved is automatically sent out. This automation only applies to Primary claims. Since Secondary claims depend on the Primary, we don’t allow edits on Secondary claims.
When you’re ready to charge the Secondary insurance, that can be done through Advanced Actions.