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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 claims status before you even received the EOB, two weeks from the date of the claim!

Wouldn’t you jump on that?  That means 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 rejections and no payment.

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

How to run the report

  1. On the Location Tab, click on eServices and Reports to get up to date reports.

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  1. Look for Claim Status labled RPXXXXXX.html report and click the hyperlink file name.  *On this screen shot it is the first, third and fourth file name.

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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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