Phase 4 Entrance Criteria

  • Payer Agreement

  • Status Control

    • Understanding Filters

    • Understanding Search Claims

    • Understanding Review Claims

    • Understanding Interface Claims (If Applicable)

    • Understanding Update Status and submit batch of Live Claims

    • Understanding RTCS Results

  • Claim Tracker

    • Understanding Track Live Claims

    • Able identify and review clearinghouse and payer acceptance and rejected claims

    • Able to Create Filters (Yesterday, Last 7 days, & Last 30 days) search claims

    • Understanding and Read results - example Correcting, resubmitting and marking as Error Fixed

    • Understanding Right-click capabilities: Open Claim etc

    • Understanding and able to view Reports (Clearinghouse & Payer Generated), proof of timely filing (CA, SR, SB and SE files)

  • Follow-up Management

    • Understanding Filters

    • Able to search claims submitted

    • Understanding batch options, adding notes, set follow-up, claim status

    • Understanding follow-up screen, reference information, contact payer info, benefits of using Expected Payment info

    • Understanding how to add Follow-up Note