Claim Management

Find or edit a Claim

Follow the steps below to find or edit an existing claim.

  1. Select Claim > Claim.

  2. Use the Search field to search for your claim.

    Place a check in the “Show exact matches only” box to search for exact matches or “Show unpaid claims only” to show claims that may need follow-up.

  1. Open the claim.

  2. Optional: Modify the claim information.

  3. Click Save. Otherwise, click Close if no changes were made.

Managing Incomplete Claims

Claims may be marked as incomplete for multiple reasons. Incomplete claims will not be sent to the clearinghouse or the payer. 

Follow the steps below to identify why a claim is incomplete:

  1. Select Claim > Claim.

  2. Use the Search field to search for your claim. 

    Place a check in the “Show exact matches only” box to search for exact matches or “Show unpaid claims only” to show claims that may need follow-up.

  1. Open the claim.

  2. Hover your mouse over the Claim is incomplete icon.

  3. A window will open providing you with additional information as to why the claim is incomplete. 

  4. Make edits to your claim accordingly.

     If the patient's record is incomplete and you're unsure why, please open the patient's record and follow the same steps as above.

  5. Once all required fields are complete the claim will automatically be marked as Completed .

  6. Click Save.


Quick Tip: How to find Incomplete Claims

Follow the steps below to find all of your incomplete claims using the report viewer.

  1. Select Reports > Viewer

  2. Search for the Incomplete Claims Report and click to open it.

  3. Select the date range and any applicable filters

  4. Click Run Report.


Delete a Claim

Follow the steps below to delete an existing claim.

  1. Select Claim > Claim.

  2. Use the Search field to search for your claim.

    Place a check in the “Show exact matches only” box to search for exact matches or “Show unpaid claims only” to show claims that may need follow-up.

  3. Open the claim.

  4. Click the Delete button.

  5. When the confirmation window opens, select Delete Claim

Print Options

Print Option provide the capability for users to print, copy, or show a preview of how the claim will print. Follow the steps below print your claim, view a preview or print a copy. 

  1. Select Claim > Claim.

  2. Use the Search field to search for your claim.  

    Place a check in the “Show exact matches only” box to search for exact matches or “Show unpaid claims only” to show claims that may need follow-up.

  1. Open the claim.

  2. Click the Print button and choose one of the following actions:

    1. Save and Print Claim: Prints the claim from your desired printer.

      Make sure the appropriate claim form(s) are loaded in the printer before selecting this option!

    2. Show Preview: View what the claim will look like once printed on the form. 

    3. Copy: Prints a copy of the claim for your record or to provide to a patient. 

  3. Click Save. Otherwise, click Close

Review Claim

Claim Review helps you manage the complex rules and terminology of coding. This feature analyzes the claim(s) before submission to the clearinghouse and identifies any issues with your claim(s), maximizing the potential for you to be paid correctly on the first submission. Claim review is made up of 3 parts.

  1. Real Time Claim Submission (RTCS): Real-Time Claim Submission (RTCS) gives you on-demand visibility into your claim. Within seconds, claims are scrubbed for tens of thousands of clearinghouse edits. 

  2. Claim Analysis: Claim Analysis is a built-in clearinghouse edit engine that validates professional and institutional claims for Generic or Payer-Specific Edits. This feature allows you to correct claims before it’s rejected by the Clearinghouse. Analyzing your claim prior to it being sent to the Clearinghouse will save you a significant amount of time on rework.

  3. Code Scrubbing (If the service is enabled): Code Scrubbing is a solution that validates your procedure codes, diagnosis codes, CCI, NCD, LCD, HCPCS, Modifiers, and LMRPs to catch any common errors before the claim is sent to a payer.

Follow the steps below to review a claim.

  1. Select Claim > Claim.

  2. Use the Search field to search for your claim. 

    Place a check in the “Show exact matches only” box to search for exact matches or “Show unpaid claims only” to show claims that may need follow-up.

  3. Open the claim.

  4. Click the Review button and select one of the following options:

    1. Review Claim.

      If the claim hasn't been reviewed yet the following message will appear in the drop-down “This claim has not yet been reviewed.”

    2. View Results.

      If the claim has been reviewed, you will see  the date and time it was last reviewed and allow you to click “view results”.

  5. A Claim Review Result window will open with a summary of the review.

  6. Click Close.

View Claim Activity

Follow the steps to pull an activity listing for a patient’s claim.

  1. Select Claim > Claim.

  2. Use the Search field to search for your claim. 

    Place a check in the “Show exact matches only” box to search for exact matches or “Show unpaid claims only” to show claims that may need follow-up.

  1. Open the claim.

  2. Click the Activity button and select one of the following options:

    1. For This Claim Only: Select this option to view activity history for the patient and will include only the claim you currently have open under the claim activity listing.

    2. For All Claims: Select this option to view the activity history for the patient and will include all claims created for the patient you currently have open. 

      If reviewing results for a new claim that hasn’t been saved, the system will return data related to the Active Patient’s debits, credits, statements, payments, insurance payments, and activity summary.

  1. An Activity window will open in a new window. 

  2. Click the View Options button.

    1. Order Claims by Newest to Oldest or Oldest to Newest.

    2. Check the Show Entered Date to display the date any payment or claim was entered.

    3. Click into the appropriate radio button to display a Summary or Detailed view.

    4. Use the Charge Filter option to filter by All Claims, Specific Claims, Unpaid Claims, Claims based on Status, or Claims in Date Range. 

    5. Use the Show Aging Balance drop-down menu to filter by Date of Service, Date Entered, Last Billed Date, Payment Plan Due Date.

    6. Click Apply.

  3. Optional: On your keyboard, Ctrl+P to print the activity listing of the patient. 

  4. Click Close to exit the window.

View Claim Summary

Follow the steps below to view a summary of the claim. 

  1. Select Claim > Claim.

  2. Use the Search field to search for your claim. 

    Place a check in the “Show exact matches only” box to search for exact matches or “Show unpaid claims only” to show claims that may need follow-up.

  1. Open the claim.

  2. Click the Claim Summary tab from the side panel.

  3. Review the claim information. 

  4. Optional: Set a Follow Up date

  5. Click Save.

Manage Claim Notes

Notes can be used to include any special information regarding a specific claim (e.g., follow up notes or patient interaction). Notes can be viewed by all users that have permission to access the Claim screen. Using the notes feature can help your team stay organized and up to date on general claim information or specific actions to come. 

Add, view or edit claim notes.


  1. Select Claim > Claim.

  2. Use the Search field to search for your claim.

    Place a check in the “Show exact matches only” box to search for exact matches or “Show unpaid claims only” to show claims that may need follow-up.

  1. Open the claim.

  2. Click the Notes tab from the side panel.

  3. Chose to add Follow Up Notes or Patient Notes by clicking on the tab.

    The Patient Notes tab allows you to categorize your notes by: Relative Notes, Patient Notes, Claim Notes, Payment Notes, Appointment Notes, My Notes.

  1. Select one of the following actions:

    1. To add notes, click the Add Note button.

    2. To edit or view notes, click into the Note for it to open in a pop up.

  2. Click Save.


Delete claim notes.


  1. Select Claim > Claim.

  2. Use the Search field to search for your claim.

    Place a check in the “Show exact matches only” box to search for exact matches or “Show unpaid claims only” to show claims that may need follow-up.

  1. Open the claim.

  2. Click the Notes tab from the side panel.

  3. Select whether to remove Follow Up Notes or Patient Notes by clicking on the tab.

  4. Click the Delete note  icon to delete any notes for this claim.

  5. Click Save.

Manage Patient Alerts on Claims

CollaborateMD allows you to add specific alerts to a patient record. These alerts will appear as a pop-up whenever the patient is opened in any sections of the CollaborateMD applications. 

Follow the steps below to add alerts to a claim. 

  1. Select Claim > Claim.

  2. Use the Search field to search for your claim.

    Place a check in the “Show exact matches only” box to search for exact matches or “Show unpaid claims only” to show claims that may need follow-up.

  1. Open the claim.

  2. Click the Alerts tab from the side panel.

  3. Click the Add Alert Button.

  4. Write the message you would like appear in the alert.

  5. Use the Display Options boxes to determine when you would like the alert to appear.

    For more information on  the Display Options, please visit the Alert Control Help Article.

  1. The Effective date Range allows you to set how long the alert should remain active.

  2. Once satisfied with the alert, click Done

  3. Click Save. 



By default you are only allowed to edit or delete alerts you created. Users with the “Create and Edit All” Alert permission is able to edit and delete any report. Please reference our User Management Help Article for more information. 

Follow the steps below to find, edit or delete an existing claim alert. 

  1. Select Claim > Claim.

  2. Use the Search field to search for your claim. 

    Place a check in the “Show exact matches only” box to search for exact matches or “Show unpaid claims only” to show claims that may need follow-up.

  1. Open the claim.

  2. Click the Alerts tab from the side panel.

  3. Click the alert you want to edit.

  4. Make the desired changes.

  5. Click Done. Otherwise, click Close to exit or Delete to remove the alert. 

  6. Click Save.


Manage Documents for a Claim

Add a document to a claim.


  1. Select Claim > Claim.

  2. Use the Search field to search for your claim. 

    Place a check in the “Show exact matches only” box to search for exact matches or “Show unpaid claims only” to show claims that may need follow-up.

  1. Open the claim.

  2. Click the Documents tab from the side panel.

  3. Select whether the document is Patient Document or Claim Document.

  4. Click the Add button and choose how you want to associate a document:

    1. Select Associate Existing to choose a document that’s already been uploaded.

      1. Drill down into the appropriate folder.

      2. Click the document you want to associate.

      3. Click Save.

    2. Select Upload New to open a new window.

      1. Click the Add Files button.

      2. Select the file from your local drive.

      3. Add any applicable note.

      4. Choose the Folder Location to add the file.

      5. Click Select.

      6. Click Upload Files.

  5. Click Save.


Delete claim documents.


  1. Select Claim > Claim.

  2. Use the Search field to search for your claim. 

    Place a check in the “Show exact matches only” box to search for exact matches or “Show unpaid claims only” to show claims that may need follow-up.

  1. Open the claim.

  2. Click on the Documents tab from the side panel.

  3. Click the Delete  icon next to the claim document file you want to delete.

  4. Click Save.


Apply Account Credit to a Claim


Who can use this feature?

Users with the Patient Payment permission can post patient payments within the Claim section. 


Follow the steps below to apply a credit. 

  1. Select Claim > Claim.

  2. Use the Search field to search for your claim. 

    Place a check in the “Show exact matches only” box to search for exact matches or “Show unpaid claims only” to show claims that may need follow-up.

  1. Open the claim.

  2. Click on the Payment tab from the side panel.

  3. Fill in the button for Apply Account Credit to Claim.

    1. The Credit Available will display.

    2. Populate the Applied Amount field with the amount of credit to apply. 

    3. Select the Received Date.

    4. The Memo field is defaulted to Apply Account Credit. If necessary, update the memo per your business needs.

  4. Click Save.


Post New Payment to Claim

Follow the steps below to add patient payments to a claim.

  1. Select Claim > Claim.

  2. Use the Search field to search for your claim. 

    Place a check in the “Show exact matches only” box to search for exact matches or “Show unpaid claims only” to show claims that may need follow-up.

  3. Open the claim.

  4. Click on the Payment tab from the side panel.

  5. Fill in the button for Post New Payment to Claim.

  6. Enter the Payment Amount.

  7. Populate the Payment Received Date.

  8. If applicable, enter the Check #.

  9. Fill in the button: Copay or Payment.

  10. Fill in the button Source: Check, Cash or Credit Card.

  11. Update the Memo field as needed.

  12. Click Save.

Post New Payment to a Claim


Who can use this feature?

Users with the Patient Payment permission can post patient payments within the Claim section. 


Follow the steps below to add patient payments to a claim.

  1. Select Claim > Claim.

  2. Use the Search field to search for your claim. 

    Place a check in the “Show exact matches only” box to search for exact matches or “Show unpaid claims only” to show claims that may need follow-up.

  3. Open the claim.

  4. Click on the Payment tab from the side panel.

  5. Fill in the button for Post New Payment to Claim.

  6. Enter the Payment Amount.

  7. Populate the Payment Received Date.

  8. If applicable, enter the Check #.

  9. Fill in the button: Copay or Payment.

  10. Fill in the button Source: Check, Cash or Credit Card.

  11. Update the Memo field as needed.

  12. Click Save.

Send Claims to Secondary or Tertiary Insurance

CollaborateMD maintains a marker in the payer database that identifies whether a payer accepts secondary claims electronically. When an insurance payment is entered via EOB Auto Apply, the application will look for a remaining balance and whether the claim has a secondary payer. If there is a balance and a secondary payer, the application will the charge status to “Send to Secondary via Clearinghouse” (as long as the payer is willing to accept electronic secondary claim(s)). If needed, please reference our Payer Agreements Help Article to learn how to submit and review payer agreements. 

Once verified that the payer will accept secondary claims electronically and the agreement has been approved, follow the steps below:

  1. Post the payment received from the primary insurance Please reference our Post Payments Help Article for more information on how to post insurance payments..

    Sometimes a payer will send an EOB where the check amount is $0.00. In these instances, a payer acknowledges the charge but will not reimburse you for the service, such as when a client has a deductible. If the patient(s) listed on the EOB have a secondary insurance and the claims can be submitted electronically to the second payer, you must post the $0.00 payment. Otherwise, the claim(s) will be rejected.

  1. Once the payment is posted, change the line item Status under the Charges tab of the Claim to bill the “Secondary Payer via Clearinghouse.”

  2. CMD will automatically send the primary insurance payment details as long as there’s a payment and adjustment made to each line item, even if the payer paid $0.00. The payment information that is transmitted electronically acts as the paper EOB the payer would normally receive.

Important Note

If the secondary payer does not accept secondary insurance claims electronically, the application will set the charge status to “User Print and Mail”.


Secondary claims can be billed the same day the primary payment is applied, and Tertiary claims can be billed the same day the secondary payment is applied,  accelerating reimbursement. It’s important to remember that these claims must be printed and mailed to the payer and the EOB must be attached to the claim.  

Re-submit a Claim

Follow the steps below to re-submit a claim.

  1. Select Claim > Claim.

  2. Use the Search field to search for your claim. 

    Place a check in the “Show exact matches only” box to search for exact matches or “Show unpaid claims only” to show claims that may need follow-up.

  1. Open the claim.

  2. Change the claim Frequency field.

    1. 7 - Replacement of Prior Claim: This is replacing a prior claim.

    2. 8 - Void/Cancel Prior Claim: This is voiding or canceling a prior claim.

  3. Provide an Original Claim #, under the Insurance information.

    The original claim# can be either the TCN (Transaction Control Number) or ICN (Insurance Control Number). Typically, the number to use is dependent on whether you’re re-submitting the claim before (TCN) or after (ICN) the EOB has been received.

  1. For Professional Claims ONLY: Click the Additional Info tab and enter a Resubmit Reason Code.

  2. Click the Charges tab.

  3. Under Charge Options, use the drop-down menu to select the status to Set all charges to. Or send by individual line item by updating the Status.  

  4. Click Save.