Charge Status Descriptions

  • Send To Payer Via Clearinghouse: Claim/Charge(s) will be sent to the payer according to your Real Time Claim Submission Settings (RTCS). 

  • User Print & Mail to Payer: Claim/Charge(s) in this status can be printed individually or in a group via the Claim Batch screen. 

  • Balance Due Patient: Outstanding Claim/Charge(s) balances with this status are added to the patient balance and are included in patient statements. 

  • On Hold: The Claim/Charge(s) is on hold and will not leave the system. This status should be used if further actions are required on this before sending to the payer. 

  • Claim at Payer: The Claim/Charge(s) is at the payer. Claims/Charges are automatically set to this status after being sent to the payer or printed from the application. 

  • Incomplete: The Claim is not complete and will not leave the system. Claims will automatically be set to this status if the claim or patient record are missing required fields (Note: Users are not able to manually set a charge to a status of incomplete).

  • Pending Payer: Outstanding Claim/Charge(s) balances with this status are added to the Insurance balance.

  • Pending Patient: Outstanding Claim/Charge(s) balances with this status are added to the patient balance, but are not included in statements. This is helpful if you are waiting for a patient payment, but don’t want to send them a statement. 

  • Pending Physician: Hold status for Claims/Charges(s) that are pending the office/provider.

  • Collection: Removes Charge Balance(s) from AR. We recommend using this status if the outstanding balance has been transferred to internal collections or an external collections agency..

  • Paid: The Claim/Charge(s) has been paid.

  • Deleted: Deletes the Claim/Charge(s) upon saving the claim.

  • Waiting for Review: The Claim/Charge(s) needs to be reviewed and status updated before it will be sent to the payer. Claims created via an interface will be left in this status.

  • Appeal at Payer: This Claim/Charge(s) is being appealed by the payer.

  • Denied at Payer: The Claim/Charge were denied by the payer.

  • Rejected At Clearinghouse: The Claim/Charge(s) were rejected by the clearinghouse.