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At a Glance

When you open a claim, everything you need to decide what to do next lives on a single scrollable page — the claim’s data, the actions you can take, the full history of submissions and payments, and a running activity feed. This guide explains how a claim is laid out and how to read its context so you can answer “what happened to this claim, and what do I do now?” without leaving the page. To submit or resubmit once you’ve reviewed a claim, see Getting Started with the Claims Page.

The Claim Lifecycle

Understanding where a claim sits in its lifecycle makes the rest of the page easier to read. The claim lifecycle from a signed note through submission and payment
  1. A note is signed. A provider signs a chart note in your EHR (Air or an external system).
  2. The claim is created. The encounter is transformed into a claim and appears on the Claims Page.
  3. Billing rules run. When you preview a submission, the claim runs through the billing rules engine, which cleans it up for the payer.
  4. The claim is submitted to the payer through the clearinghouse.
  5. Status is tracked. Submission errors, rejections, denials, and remittances all surface back on the claim.
The Claims Page is designed to be your single source of truth. Everything about a claim — its status, its submissions, how it paid, and what to do next — lives on the claim itself.

How a Claim Is Laid Out

Opening a claim shows one scrollable page (no clicking through section after section). It has four areas:
  • Controls — jump to any section of the claim, even when the panel is minimized, and Review claim to dry-run it through billing rules before submitting.
  • Claim details — the same content as the classic encounter details, all on one page: patient, insurance, provider, diagnoses, and procedures. This is where you add or edit claim data.
  • Actions — the primary Submit action sits prominently in blue; every other action (push to PR, adjust, request an appeal, defer, preview submission) lives in a secondary menu.
  • Claim context — the panel alongside the claim that brings together everything that has happened to the claim.

Reading Claim Context

The Claim Context panel (expandable to full width) is where you diagnose a claim. It has four key sections. The Claim Context panel showing claim details and history side by side
  • Status Reason — explains why a claim is in its current work queue. It shows the denial, rejection, or error code, a plain-language description, the aggregate dollar amount, and a per-procedure breakdown. It updates automatically as the claim’s situation changes.
  • Submissions — the full history of every submission on the claim. Click into any one to see the payload, its metadata, the billing rules that were applied, and the CMS-1500 (or UB-04) PDF for that submission.
  • Remittances — remittance data with its source and deposit-verification status. You can download the raw 835 (ERA) file or a PDF.
  • Payments — every payment on the claim. Group and sort by posted date, check number, submission ID, or procedure, and use Display Settings to control which columns appear (including a denied-reasons column). Click any payment for full detail.
When you open a per-payer view and a per-procedure view at the same time, the same payment can appear twice. This is a display quirk, not a duplicate payment — check the payment detail if a total looks off.

Common Events You’ll See

As a claim moves through its lifecycle, these are the events you’ll encounter in its history:

The Activity Feed

The Activity Feed tracks the full chronological story of a claim, from creation to finalization. System-captured events (like “procedure added”) and user comments appear together in time order, so you don’t need to narrate your own actions — the system already records what you did. Add a comment only when it adds context the system can’t capture, such as a payer reference number or the next step you’re waiting on. Responsibility changes, assignments, and deferrals all appear in the feed with their reasons — click view more to read the note. Reach the feed quickly using its icon in the claim panel, which scrolls you straight to it.
Smart Tip: Before you start working a claim, skim the Activity Feed. It tells you what a teammate already tried, what a payer said, and whether the claim is waiting on something — so you don’t duplicate work.

Responsibility and Assignment

Every claim is either your site’s responsibility or Athelas’ responsibility.
  • When a claim is Athelas’ responsibility, site users simply see the Athelas logo as the assignee — all you need to know is that Athelas is handling it.
  • Filter by responsible party to see whether a claim belongs to your site or to Athelas.
  • Reassigning responsibility in either direction requires a note, which is logged to the Activity Feed so the reason is always captured.
You can also assign a claim to a specific teammate so ownership is explicit in the queue. This removes the “I thought you had that one” ambiguity — for example, handing a denial to a senior biller for appeal. Assigned claims surface in that person’s My Claims view.

Previewing Billing Rules Before You Submit

Before submitting, use Review claim (or Preview Submission) to dry-run the claim through billing rules. The left side shows your input; the right side shows the output after rules run — for example, an updated zip code, referring provider, or NPI. Previewing a submission after billing rules run, with the option to edit
  • A star indicator next to a field means a rule applied and modified that field.
  • View Rules shows which billing rules fired; you can search within them for a specific field.
  • View PDF renders the CMS-1500 or UB-04 form. Remove the background to print directly on RED-certified CMS-1500 paper.
The dry run can surface three kinds of results:
You can edit the submission directly after rules run, but those edits bypass the billing rules engine. Treat it as a workaround for a misbehaving rule — for routine changes, edit the claim instead so the change is tracked and posts correctly.

FAQ

It’s now the Activity Feed inside the claim, combined with the Submissions history in Claim Context. Together they show the full chronological life of the claim — submissions sent, payments received, and changes made — in one place, without a separate timeline tab.
No — and that’s intentional. When a payer posts a payment, the remittance lives inside Claim Context on the claim itself. Open the Remittances section to see the ERA/EOB detail, CARC/RARC codes, adjustments, and paid-vs-billed amounts without leaving the claim.
A star means a billing rule applied and changed that field during the dry run — for example, correcting a Place of Service code or adding a modifier. Use View Rules to see exactly which rule fired and why.
That claim is Athelas’ responsibility, and the Athelas team is handling it. There’s no action needed on your side. Use the responsible-party filter to separate Athelas-owned claims from your site’s own worklist.