Payer Agreement Status Descriptions


 Status Definition
Authorized

Represents a payer authorization and a completed setup with the clearinghouse.

Authorized Exception

Agreements where the payer has authorized some but not all of the providers on the agreement.

Canceled

Represents a customer request that an agreement be canceled.

Closed

Forms closed unrelated to standard agreement activity.

Deauthorized

The customer requests that the authorization was removed.

Denied - Payer

Represents a denial by the payer; a new agreement must be submitted.

Denied - Pending

Represents a denial by the clearinghouse (typically missing provider information); Information can be sent via return email.

Denied - Pending Expired

The agreement has been held in a Denied-Pending status for 90 or more days without receiving updated provider information.

Denied - Pending Updated

The clearinghouse has received updated provider information from the customer and the agreement has been re-entered into the system for review.

Denied - Rejected

Represents a denial by the clearinghouse; a new agreement must be submitted.

Enrollment Submitted

Agreement has been submitted. This does not reflect the actual approval or denial of the agreement.

Needs Test

Represents a payer approval, but the payer requires testing data for the provider.

Open

Agreement is pending approval with the payer.

Pending Setup

Represents a payer authorization with additional setup required at the clearinghouse.

Pending Receipt

Agreement is pending Customer.  An item is required to be submitted to the agreement submitted. Example: Original form required to be mailed. Pending receipt of agreement to be received in the mail.

Rescan

Agreement had to be modified by the clearinghouse before sending it to the payer.

Under Construction

The clearinghouse is updating the agreement per new payer requirements. You may check back for access to complete within 3-5 business days.

Unavailable

The Agreement is no longer available or supported by the clearinghouse.