Processing Events and System Notes

Processing Events are clearinghouse or payer messages that provide information about claim receipt and processing. They can be status updates from the payer or information generated by the clearinghouse. System Notes are updates alerting users to events in the claim life cycle. Use these notifications to determine what next steps are needed to get the claim processed.

System Notes

Any note labeled SYSTEM will appear in a claim's Show Notes section. System notes are automated notes that require attention, like a payment notification or claim rejection.

Payment-related system notes are notifications that an electronic EOB has been uploaded into Avea.

When this happens, a note generates detailing which payer the EOB is from, the payment number, the payment date, the queue change, and the follow-up date.

If the payment was fully matched to the related claim, Avea will automatically send the claim to a Review Queue in the Work Center and set the follow-up date for the next business day.

If a claim number is recognized, but other payment information requires mapping, a system note will generate but the corresponding payment will not attach to the claim. To fully map the payment, navigate to the Review Queue in the Work Center. Click here to learn more.

Note: To obtain information on a system note, see the Processing Events tab for a more complete summary of claim stages, or the Payments tab for more details about the payment.

Processing Events

To see processing events, click on the AveaOffice claim number from any Work Center page and choose the Processing Events tab.

Notifications appear in the Processing Events tab during the clearinghouse claim-scrubbing process and after, when the claim transitions to the payer. The messages vary depending on what the payer communicates to the clearinghouse.

When claims are sent to the payer, a notification appears in the Processing Events Tab. Payers sometimes send a Payer Claim Tracking Number, also known as an Internal Control Number (ICN). This number is generated by the payer when a claim is received and then forwarded back to the clearinghouse. It often correlates to an image number or claim number in the payer’s system and can be used as proof the claim was received. This number is necessary when submitting corrected claims as it provides the payer with a link to the claim that is being corrected.

Tip: Use this number during claim follow-up if representatives are having trouble locating a claim.

Notifications about claims being Held or Pended often require a call to the payer to resolve the issue. For Held or Pended claims, the payer is typically requesting some sort of information. 

These notes can show up in the Currently Held/Rejected Claims, the Processing Events Tab, or as a System Note in the Claim Notes Section.

FAQ

Why haven't the processing events been updated when the claim says it's submitted?

Processing events are synced to claims in a nightly process (once per 24-hour period). If you see your claim is submitted but no processing events have been recorded, recheck them the next morning.