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tsalcido
CS Dental Employee
CS Dental Employee

Did you Know: The Claims Status Report? Fix rejections earlier before EOB

Did you know about the Claims Status Report?

What if I told you that this whole time the Claim Status report that comes from the insurance company a few days after claims have been sent,  will show you what claims have been rejected, accepted or required documents needed ( i.e., images or charting)?

What if I told you to go into your electronic services right now and pull up your Reports, view the report titled Claim Status and  you will see from two days ago claims status before you even received the EOB, two weeks from the date of the claim!

Wouldn’t you jump on that. That would mean you can open up the Claim Status Report to see rejected claims and the reason or required documents  and fix it prior to getting the EOB!!!

Did I say this already, you don’t have to wait two weeks from now only to see the EOB show no payment with a rejection.

Stop what you are doing and go do this. So Happy I could help!

 

How to run the Claim Status Report

  1. Open your eServices reports under File.

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  1. Click on Retrieve Reports to get up to date reports.

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  1. Look for Claim Status report and highlight the file name. Click Preview

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  1. The file will look like this- Each field will show the patient’s information and details.

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CLAIM STATUS REPORTS – this report is sent from the clearinghouses and insurance companies a few days after your claims are sent. It indicates the status of your e-claims.

It is important to watch for rejections on claim status report!!

  • “ACC” = accepted by the clearinghouse or insurance company
  • “REJ” = claim is rejected by the insurance company and this report will list the reason why. These claims must be fixed resubmit—or (in the case of rejection for lack of coverage) the balance should be billed to the patient.
  • “REQ” = insurance company is requesting more information to process the claim such as x-rays or charting. Please provide the information they want by mail or phone. If you mail x-rays or charting, you will need to include the PCN number from this report along with the x-rays.

If a claim is rejected that means no payment. Fix the error on the rejection, send the required attachment and get paid in a timely fashion. 

 

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