Getting Started as a Biller

Introduction to Claim Details Tab for understanding all actions taken and status of each claim submitted:

Claim details houses all claim information, status, charges, and payments

Your practice will likely have several thousand claims listed here, the many filters available will drastically decrease the time you spend sorting through them manually.

You can also always simply start typing in the Search bar to find what you’re looking for.

For example, this list has been filtered to show only claims with an Encounter Status of ‘Approved.’

Viewing Denials from the Claim Details page

Because many people also use the Claims Details page to analyze denials, there’s a filter to let you see any denials visible in the Denials Worklist:

Individual Encounter Details

Clicking into an encounter will allow you to view and edit a wide range of information about that encounter.

Payment Overview

The Payment Overview tab features a summary of the claim and whether it has been balanced or not.

It is organized both ‘per payer,’ just below the summary, and also ‘per procedure.’ By expanding these sections, you can dig into the reasons for its status, as shown in this example.

From the Submissions tab, you can expand a submission to view more details. You can also click on the ‘x rules applied’ button to view which rules were applied to this claim.

Patients tab

This tab displays all touch points (texts or emails) between your practice and the patient regarding PR collection, as well as their results.

You can also use this feature to assess the effectiveness of PR collection through these methods for a given patient, and adjust PR collection strategy accordingly to ensure your practice gets paid.

View details about all remittances related to this encounter here. You can also download them in bulk in the top right corner.

Claim Timeline

The Claim Timeline displays all events that have occurred in relation to that claim, including payment updates. This is a particularly useful visualization tool when there is some question about a claim’s status, or how much time elapsed between two events.

Change History

This is a handy tab for tracking all updates made to a claim. You can view when the update was made, which fields were changed, and who made the changes. If you’d also like to see instances of updates with no change, you can click the toggle to ‘Show all imports.’

Click ‘View’ for more details on a given update.

View the patient’s eligibility status here.