PERMISSIONS: You need Billing permission to change a claim's status.
You can manually move a claim to a different status when an action happens outside of the system. For example, you may want to move print-only claims to the Submitted status when you mail them so you know where those claims are in the process.
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Change a Claim's Status
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- Go to Billing → Claims and click a claim status to see the claim list.
- Select the checkbox next to one or more claims
- In the lower right, click the Change status button.
- Go to Billing → Claims and click a claim status to see the claim list.
NOTE: You can also change a claim's status from the claim form with the Status button in the upper right.
About Claim Statuses
A claim's status typically indicates where it is in the billing process:
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- Claims start in Reviewing, where they can be reviewed and submitted to the payer.
- Claims in Waiting have been returned to the therapist so corrections can be made on a daily note.
- Claims in Queued are being processed by Fusion and submitted to the clearinghouse.
NOTE: If a payer is set to print only and generate a claim, then the claim will not move forward to next status without being manually changed. Print-Only payers do not have a Remitter/Payer ID in Admin Settings on the Payer List.
- Claims in Submitted have been received by the clearinghouse and are being sent to the payer.
- Claims in Accepted have received an acceptance message from the payer and are being processed.
- Claims in Rejected have received a rejection message from the payer.
- Claims in Not Paid have been processed by the payer and are linked to a remit with a denial.
- Claims in Paid have been processed by the payer and are linked to a remit with a paid amount.
- Claims in Completed have been finalized to a billing account.
| Status | Meaning |
| Waiting | The claim was generated but isn't ready to bill because it's waiting on other same-day claims, and has been sent back to the therapist for changes. |
| Reviewing | The initial claim status. Claims stay here until submitted. |
| Queued | Electronic claims that have been marked as ready to send but have not yet been sent to the clearinghouse |
| Submitted | Claims that have been submitted electronically but have not yet received an acceptance message back from the clearinghouse |
| Accepted | Claims that have been submitted electronically, and Fusion has received an acceptance message back from the clearinghouse |
| Rejected | Claims that have been submitted electronically, and Fusion has received a rejection message back from the clearinghouse |
| Not Paid | Claims that have an adjudication linked, but there was no payment made in the adjudication |
| Paid | Claims that have an adjudication linked, and there was any payment made in the adjudication |
| Completed | Claims that are fully finalized. All adjudications have been accepted, and there is no more work to be done for payer collections. |