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Getting Started with the Claims Page

The Claims Page is where you’ll spend most of your time managing your claim workflow. It’s designed to help you work faster with fewer errors by giving you powerful tools for filtering, reviewing, and submitting claims. Here’s what you’ll learn:
  • How to find the claims you need to work on
  • How to review and fix claims quickly
  • How to submit claims with confidence
  • How to work with your team

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Find What You Need to Work On

The Claims Page shows every claim at your practice. With thousands of claims, the key is narrowing down to exactly what you need right now.

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Start from a built-in view

Views appear as tabs across the top of the page. Everyone starts with three:
  • All Claims — every claim, with no filters.
  • Workable Claims — claims that are your site’s responsibility, need work now, and aren’t deferred, grouped by Status Reason so each bucket holds claims with the same problem.
  • My Claims — claims assigned to you.
See Organizing Your Claims Worklist for grouping, columns, and the rest of the view tools.

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Use filters to focus your work

Click Filter (or press F) to narrow down your list. Common filters include:
  • Claim Status and Status Reason — what needs to happen next, and why
  • Assignee — claims assigned to you or to a teammate
  • Responsible Party — your site or Athelas
  • Insurances — the primary, secondary, or tertiary payer
  • Dates — service, submission, created, or posted dates
  • CARC and RARC — denial reason codes
Combine filters to get exactly what you need — for example, Claim Status is Full Denials and the primary insurance is Blue Cross. If you’d rather describe what you want in your own words, choose AI filter.

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Save views for quick access

Once you’ve set up filters you use regularly, save them as a view:
  1. Apply your filters
  2. Click Save next to the filter bar
  3. Type a descriptive name like “BCBS denials” and click Save View
Your saved views appear as tabs after the built-in views, and they’re there every time you come back. Each team member creates their own views based on how they work. Common views to start with:
  • Claim Status is Needs Initial Review, to review new claims before they go out
  • Claim Status is Submission Errors or Rejections, grouped by Status Reason, to clear errors before they age
  • Claim Status is Full Denials or Partial Denials, grouped by Status Reason, to work denials by cause

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Assign claims to track ownership

Every claim should have an owner. This prevents duplicate work and ensures nothing falls through the cracks. To assign a claim: click the icon in the claim’s Assignee column and choose a team member, or open the claim and press A. To assign multiple claims at once:
  1. Select the checkboxes next to the claims (or click the header checkbox to select every loaded claim)
  2. Click Assign in the bar at the bottom of the screen
  3. Choose the team member
Claims assigned to you appear in your My Claims view.

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Review and Fix Claims

When you’re ready to work on a claim, click the claim to open it. The claim’s details sit on the left, and Claim Context — its status reason, submissions, remittances, attachments, and payments — sits on the right. See Working a Claim for a tour.

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What to check on every claim

Before submitting, verify:
  • Patient demographics - Name, DOB, address, insurance details
  • Date of service - Correct and matches documentation
  • Provider information - Correct provider and facility NPI
  • Diagnosis codes - Support the procedures billed
  • Procedure codes - Match services provided
  • Units and charges - Accurate for the services

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Let billing rules and AI help you catch errors

Problems are flagged directly on the fields that need fixing, such as missing required fields (DOB, insurance ID, provider NPI), invalid diagnosis or procedure codes, and conflicting information. When you review a claim, it runs through your billing rules before anything is sent:
  • Billing rules fix the claim automatically for the payer — an updated zip code, an added modifier, a corrected place of service. Fields a rule changed are marked so you can see what changed.
  • Skippable rules are suggestions you can skip.
  • Hard blocks stop submission until you resolve the issue. You’ll see a message explaining what needs fixing. If you can’t fix it yourself, assign the claim to someone who can.

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Preview before submitting

Click Review claim or Preview Submission to see exactly what will be sent to the payer, next to your claim. View Rules shows which billing rules ran, and View PDF shows the CMS-1500 or UB-04 form. This is your last chance to catch any issues before the claim goes out. See Previewing Billing Rules Before You Submit.

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Get help when you need it

Ask Athelas Assistant Click the Assistant button (or press C on a claim) to ask questions about the claim. Examples:
  • “Why would this diagnosis code be rejected?”
  • “What’s the correct way to code this for Blue Cross?”
  • “Does this procedure require a modifier?”
Athelas Assistant sees the same claim details and history you do, and provides guidance on coding guidelines and payer rules. Collaborate with your team Some claims need input from others. Use the claim’s Activity Feed to:
  • See all recent changes and who made them
  • Add comments and @mention specific team members
  • Reply to questions and document decisions
All communication stays with the claim, so context doesn’t get lost.

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Submit with Confidence

Once you’ve fixed all errors and previewed the claim, you’re ready to submit.

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Submit the claim

Click Submit on the claim. If the claim has been submitted before, the button says Resubmit instead. The submission appears under Submissions in Claim Context, and the claim’s status updates as the clearinghouse and payer respond. While you wait on the payer’s decision, the claim is in Decision Pending. See Claim Status, Stage & Payer Status for what each status means. Press J or K to move to the next or previous claim in your list, or Esc to return to the Claims Page.

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Handle Denials

Denials happen. When they do, your goal is to understand why, fix the issue, and resubmit quickly.

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Find your denials

Open Workable Claims, or filter Claim Status to Full Denials or Partial Denials, and group by Status Reason so each bucket holds one denial reason. Then sort or order by:
  • Balance (highest first) - Tackle high-dollar denials first
  • Time in Status (longest first) - Work the claims that have waited longest
  • Insurances - Spot patterns in denial reasons by payer
If you see the same denial reason across multiple claims from one payer, flag this pattern to your team lead.

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Fix and resubmit

  1. Open the denied claim
  2. Read Status Reason in Claim Context to see the denial codes, their descriptions, and the denied procedures
  3. Check Remittances for the full ERA with additional details
  4. Make corrections based on the denial reason
  5. Add a comment to the Activity Feed if your fix needs context, such as a payer reference number
  6. Click Resubmit
To fix the same problem on many claims at once, see How to Resubmit Claims in Bulk. Common denial reasons and fixes:
  • Missing/invalid information - Add missing demographics, insurance details, or authorization numbers
  • Coding errors - Correct diagnosis or procedure codes, add required modifiers
  • Duplicate claim - Verify if already paid or add note explaining it’s not a duplicate
  • Medical necessity - Add documentation or escalate to provider
  • Timely filing - Document original submission date if submitted on time
Note: Timely filing deadlines vary by payer and are strict. If you’re approaching the deadline, prioritize that claim immediately.

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Understanding Claim Statuses

Every claim has a Status, which tells you what needs to happen next, and a Stage, which tells you which party holds the balance. A claim’s Status Reason explains why it’s in its status. Claim Status, Stage & Payer Status lists every status and which ones are workable.

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FAQ

Start in Workable Claims, which opens grouped by Status Reason with the highest-balance groups first. From there:
  1. Claims nearing timely filing deadlines - Sort by date of service
  2. High-dollar buckets - Order groups by balance
  3. Claims stuck in one status - Sort by Time in Status
Save a view for each priority and switch between them as you work.
Fix the claim itself where you can, and add a comment explaining why. You can also edit the submission directly after rules run, but those edits bypass the billing rules engine — treat that as a workaround for a misbehaving rule. If you see the same rule misbehave for a payer, report it to your team lead.
No. Error flags indicate problems that will likely cause rejections or denials.Fix all flags before submission; a few minutes now saves denial rework later. If you can’t fix a flag, assign the claim to someone who can.
Use the claim’s Activity Feed:
  • Add comments to ask questions or flag issues
  • @mention specific team members to notify them
  • Review the change history to see what others have done
All communication stays with the claim so context doesn’t get lost.
Yes. Click Display at the top right of the Claims Page and turn columns on or off under Display Properties. Your column choices save with your custom views.Common column setups:
  • For submission work: Status, Patient, Provider, Date of Service, Charges, Assignee
  • For denials: Status, Time in Status, Patient, Insurances, Balance, Assignee