Claim Statuses

Claim Status is a tag added to the claim to indicate its current lifecycle stage. You can create custom statuses to match your organization's billing workflow or edit existing statuses from the Managing Organization Admin.

User Permissions

Admin-level user profiles can assign and update statuses without additional user permissions. Organization Users and Managing Organization Users will require Edit-level permissions under Insurance Claim Access in the user profile. To read more about user types and permissions, click here. 

Create and Manage Claim Statuses

Your Organization's account will include default statuses related to claim submission. Upon submission, the claim status Payer—Original Claim Processing will be attached to the claim. After resubmitting a claim, the status Payer—Resubmitted will be attached to the claim. 

Only Managing Organization Admins can create and update statuses in the Managing Organization Admin section and adjust default queues for claims based on claim behavior. Let's review the processes together!

• 1. Navigate to the Managing Organization Admin and click Configuration.
     
  2. Next, click Claim Statuses.
     
  3. Select Create Claim Status Type.
     
  4. Name the new status.
     
  5. Finally, select Create to complete the process.
     
• 1. Navigate to the Managing Organization Admin and click Configuration.
     
  2. Next, click Claim Statuses.
     
  3. Locate the status name and select Edit.
     
  4. Make the desired changes.
     
  5. Click Save to complete the process.
     
• 1. Navigate to the Managing Organization Admin and click Configuration.
     
  2. Next, click Account Settings.
     
  3. Click Edit.
     
  4. Update the dropdown of the default status you wish to change
     . 
  5. Click Save to complete the process.