PERMISSIONS REQUIRED: You need the Billing permission to view a claim.
Always review your claims before printing or sending them electronically to a payer to make sure the information is correct.
1. Go to Billing → Claims → Reviewing to see the claims that have not been submitted yet, and a red, yellow, or green icon will appear to the right of each claim:
- A Red icon
indicates that a required field is missing or is invalid.
- A Yellow icon
indicates that something on the claim form is different from the source information.
- A Green icon
indicates that neither of the potential concerns above have been detected.
2. Click a claim to open it. This will show the claim's information on a CMS-1500 form.
3. Look for any fields highlighted in red, orange, or yellow, and decide if you need to make any changes.
- A red highlight means the system detected a problem with this field, and the claim can't be sent electronically until it's corrected. Click the field to view a note that may help you make a correction and change the field's status back to "Normal".
- An orange highlight means there's a difference between what's on the claim and the source information on the patient, payer, or daily note. For example, if the insured's address has been updated in the patient's information, but not on the claim form. The claim can still be sent even if you don't make changes.
- A yellow highlight means a note has been added to this field. Click the field to view the note. The claim can still be sent even if you don't make changes.
4. Review the rest of the claim to make sure the information is correct. Once you've reviewed a claim, you can either send it through the system or print it.