Claim Queues

Claim queues are used to manage the claim follow-up process more effectively. Queues allow you to group claims into buckets that identify an action that needs to be taken, like who to follow up with or what is holding up the claim. You can create and update Queues in the Managing Organization Admin and set default Queues for claims based on claim behavior.

Queues Video

Add Claim Queue Types

Use the following instructions to add or edit existing claim statuses.

  1. Navigate to Managing Organization Admin > Configuration > Claim Queue Types.
  2. To create a new claim queue, you will need to click Create Claim Queue Type.
  3. Complete the Create Claim Queue Type form. 
    1. Name: The title of the queue you are creating.
    2. Queue View – Primary Grouping: The first grouping when viewing a queue (Issue, Organization, Payer, or Practice).
    3. Queue View – Secondary Grouping: The secondary grouping when viewing a queue in the Work Center (Practice, Payer, Organization, or Issue).
    4. Is Active: Yes or No 
  4. Click Create. 
  5. You will now be able to sort claims into the newly created queue.

Setting Default Claim Queues

Use the Managing Organization Admin > Configuration > Settings tab to set default queues for specific claim behavior. Like determining what is the default queue for the first time a claim is submitted, resubmitted, etc.

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