Internal video to help Tashia and Jessica with this feature: L1 meeting (2023-05-04 09:10 GMT-5) - Google Drive
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Benefits of using this feature
Claims tracking will allow you to track submitted claims
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via the claims tracking panel. The claim status will be updated automatically once the invoice is paid in full. All payments, patient and 3rd party payer, are located in the patient sales history.
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You will notice that you are unable to allocate money to the 3rd party payer. This is because you no longer need to separate the patient portion from the 3rd party payer portion.
Once the sale is saved, you can find the sale in the claims tracking panel under the pending claim submission tab. The pending claim submissions panel will track all invoices and orders that have not had a claim submitted to insurance.
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“clear invoice” option unchecks the to be submitted to insurance. (no longer requires a claim)
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“Submit electronically” button will still be there for clinics that have the clearinghouse integration. When they click this button it will send the claim to the submitted claim tab in the claims tracking panel.
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They can R-click the submitted claim and mark the claim as “denied, rejected, acknowledge etc”
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This table shows you the submitted amount, the amount paid, and credit amount
Hover over the invoice icon and you can see the original invoice amount
You can R-click > patient > receive payments, request online payment, issue write off
You can R-click > 3p payer > receive payments, request online payment, issue write off
You can resubmit the claim from this screen if a claim was rejected
Receive/apply bulk payment at the bottom of the screen can be used like the enter 3rd party payer
You can view claim details (clock icon) to see who did what on the claim (like event history)
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3p payer payments will appear on the patient file. Claim status will change to “paid” automatically.
Pending claim submission
This tab will show the order date, invoice #, status, patient name, location, Patient 3rd party payer(s), items, and invoice amount.
You will have several options in the pending claim submission panel:
Hover over the invoice # column to add a note, prepare HCFA, or view claim history. The claim history will track user movement on the claim. If there is no invoice #, the items have not been delivered on the patient file.
Transaction details, at the bottom of the screen, will allow you to view the invoice, but not make changes.
Edit invoice will allow you to view the invoice and adjust information.
Prepare HCFA will populate the prepare claim module. You will have the option to save as a draft, ready for submission, or submitted. These options will come in handy if you work with a 3rd party billing company. Click on the orange notepad to enter your name, date, and time in the notes.
Does not require submission willuncheck the to be submitted to insurance checkbox on the invoice and remove it from the pending claim submission panel.
Submitted claims
This tab will show the submitted date, invoice #, claim #, patient name, location, 3rd party payers, amount paid, credit amount, and open balance.
Within each claim you will have several options:
R-click the submitted claim > Patient > Receive/apply payment, Request online payment, Write-off. You can also do this by hovering over the patient’s name.
R-click the submitted claim > select the 3rd party payer > Change status > mark the claim Acknowledged, Closed, Denied, Rejected, Reopened. You can also receive/apply a payment and enter a write-off. You can also do this by hovering over the 3rd party payer's name.
3rd party payer write-offs will change the claim status to
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Patient file > 3p payers section will show the claim history with the same details as the claims tracking panel
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Patient sales history will have a new icon when the invoice requires submission. A document with a green checkmark means the claim was submitted. The payment icon means a payment was taken. entire balance will remain on the patient.
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R-click sale > view HCFA will show you the submitted claim
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R-click the submitted claim > Resubmit HCFA, Close claim, Claim history.
Hover over the Claim # column to add a note or view claim history. The claim history will track user movement on the claim.
Hover over the open balance amount to see the invoice amount as well as the submitted amount.
Receive/apply bulk payment at the bottom of the screen can be used to enter bulk payments for several claims.
Once a claim is fully paid the status will update to closed. Closed claims are removed from the submitted claims
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Patient profile
Under the 3rd party payers tab, you can view the submitted claim history with the same information as the claims tracking panel.
The patient’s sales history has new icons in the 3rd party total column when an invoice requires submission or has been submitted.
Icon | Description |
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 | Claim pending submission |
 | Claim submitted |
 | Claim rejected |
Report
The Claims Tracking (Excel only) is a new report created
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