Claim Search

This page allows you to search for one or more claims and view detailed information about a specific claim.

NOTE: You can click the icon to expand information or the icon to collapse information on this page.

This page contains one or more tables. You can click a specific column heading in a table to sort the data in the table in ascending order by the selected column. Once selected, you can click the column heading again to sort the data in descending order. When more than one page of data is available, you can click the buttons at the bottom left of the table to navigate through the various pages, or you can select a specific page in the Page drop-down list to display data for a specific page.

Search Criteria for Claims

Complete information in one or more of the following controls to search for a claim and/or filter the list of results displayed:

In Client Number, enter the specific client identification number on which to search. You can enter partial information to widen your search.
In Authorization ID, enter the specific authorization identification number on which to search. You can enter partial information to widen your search.
In Claim Entry Date, enter a specific date to search for claims submitted on the date specified.
In Service Date, enter a specific date to search for services performed on the date specified.
As a provider, the name of your provider agency is automatically selected in the Provider Agency drop-down list. This information is read-only and cannot be changed.
In Provider Site, select the name of the provider agency site on which to search.
In Level Of Care, select the level of care on which to search.

Click Search to perform a search based on the search criteria specified. The page refreshes and results found to match the search criteria are displayed in the Claims table. Or, click Reset to reset the search controls to their default values.

NOTE: If search criteria are not specified, a list of all claims displays in the Claims table when Search is clicked.

When performing a search, only the claims associated with your provider agency are displayed in the Claims table.

Search Results

The Claims table displays whenever Search is clicked. In the columns of the table, the following information is displayed for each claim that matches the specified search criteria:

Click the Details link to display detailed information about the selected claim. When clicked, the page refreshes and displays Claim Detail information.
Claim Number displays the unique claim identification number for the claim.
Claim Entry Date displays the date on which the claim was submitted.
Claim Type displays the current type of claim that was submitted.
Claim Status displays the current status of the claim that was submitted.
Authorization ID displays the unique authorization identification number for which the claim was submitted.
Client Number displays the unique identification number of the client for which the claim was submitted.
Provider Agency Name displays the name of the provider agency for which the claim was submitted.
Provider Site Name displays the name of the provider agency site at which services were provided for the claim was submitted.

Claim Detail

General Claim Information displays when the Details link in the Claims table is clicked. The following information is displayed under General Claim Information for the selected claim:

Claim Number displays the unique claim identification number for the claim.
Claim Entry Date displays the date on which the claim was submitted.
Claim Type displays the current type of claim that was submitted.
Claim Status displays the current status of the claim that was submitted.
Client Number displays the unique identification number of the client for which the claim was submitted.
Client Name displays the first and last name of the client for which the claim was submitted.
Authorization ID displays the unique authorization identification number for which the claim was submitted.
Level Of Care displays the level of care for which the claim was submitted.
Provider Agency displays the name of the provider agency for which the claim was submitted.
Provider Site displays the name of the provider agency site for which the claim was submitted.

The following information is displayed under Claim Detail Information for the selected claim:

File ID displays the unique identification number assigned the claim when it was submitted. You can select a different file identification number in the drop-down list to view specific information about the file identification number selected. The drop-down list contains a list of all file identification numbers associated with the claim. When a different file identification number is selected, the page refreshes and displays Claim Detail Information specific to the selected file identification number.
Statement Date displays the statement date for the claim.
Payment Reference Number displays the payment reference number for the claim.
Claim Adjustment Reason displays the reason the claim was adjusted, if applicable.
Current Submission indicates whether the claim has currently been submitted.

The following information is displayed in the Claim Lines table for the selected claim:

Line Number displays the unique identification number associated with the claim line item. You can click on a line number in this column to update the information for the selected claim line item. When clicked, the information in the table becomes editable and can be updated directly in the table.
Service Date displays the date on which the service was performed for the claim line item.
CPT Code displays the service code of the claim line item.
Units displays the total number of units claimed for the service line item.
First Clinician displays the name of the first clinician that performed services for the claim line item.
Second Clinician displays the name of a second clinician that performed services for the claim line item.
Amount Billed displays the total amount billed for the claim line item.
Amount Denied displays the total amount that was denied for the claim line item.
Amount Disallowed displays the total amount that was disallowed for the claim line item.
Denial Reason displays the reason the claim line item was denied.
Voided indicates whether the claim line item has been voided.

Click Correct Claim to correct the claim as necessary. When clicked, the Enter a New Claim page displays in correction mode.

Claim History

The Claim Submissions table displays when the Details link in the Claims table is clicked and historical information exists for the claim. The table displays a list of all the submissions for the claim. The following information is displayed in the table for the claim:

Entry Date displays the date on which the claim was submitted (or resubmitted).
Service Date displays the date on which the service was performed for the claim line item.
Service Code displays the service code for the claim line item.
Units displays the total number of units claimed for the service line item.
Amount Billed displays the total amount billed for the claim line item.
Amt At Rate displays the rate per unit being billed for the claim line item.
Denied displays the total amount that was denied for the claim line item.
Paid Prev displays the total amount that has been previously paid or the claim line item.
Net displays the total amount remaining to be paid for the claim line item.
Reason Denied displays the reason payment was denied for the claim line item.
Clinician displays the name of the clinician that performed services for the claim line item.
Second Clinician displays the name of an additional clinician that performed services for the claim line item.

Tutorials...

Access the Home Page

Correct a Claim

Search for a Claim

View Detailed Claim Information