This page highlights all the details in a claim.
Encounter ID
The encounter identifier used to link medical records, claims, and billing activity for a single visit.
Key Actions
Use these actions to manage the claim:
Print
Print the CMS-1500 form.
Message
Send a message about this specific encounter to a member of your team.
Sync
Sync the encounter information with your Practice Portal.
Remove
Remove the claim from the current queue.
Patient Information
This section highlights key patient information, including the patient’s name, Billing Account ID, EHR ID, primary and secondary payers, provider, date of service, and the assignee currently responsible for the case.
Service/Claim/Notes
This side tab provides additional context and detailed information to help you better understand and manage the case.
Service
View service-related details such as surgeries performed, physician notes, clinical documentation from the EHR, operative notes, hospital consult notes, other chart notes, the facility code and name, and the hospital admission date.
Claim
Review key claim information and actions, including submission dates, submission method, and other claim-related details.
Notes
Add notes about the case and document actions taken to keep your team aligned and informed.
Warning message
This warning shows the work queue the claim is in and the user currently assigned to the task.
Charges
This section highlights the total charges that were billed to the payer. It also displays the procedure codes and modifiers associated with the encounter, along with the corresponding units and diagnosis codes.
Payment Summary
This section breaks down charges at the procedure level to help you understand how each service was billed and paid. For each procedure code, you can see the number of units billed, the payer responsible, the original charge, the allowed amount, any adjustments, amounts paid by insurance and the patient, the write-off, and the remaining balance.
EOB
This section displays the EOB returned by the payer along with the associated denial codes. It also provides descriptions for each denial code.
EOB for Inactive Payer
This section displays any EOBs linked to inactive payers.
Move to Queue
Here you can move the claim to a new or different queue. When doing so, you must assign it to a user and set its status.