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.

3. Open the claim.

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

5. Review the claim information.

   1. Patient: Displays the patient's name,  account number, and reference number (when applicable). 

   2. DOB: Displays the patient's date of birth, age, and gender.

   3. Form Version: Displays the claim version (CMS-1500 or CMS-1450 (UB04)).

   4. Total Amount: Displays the total billed amount for the procedure codes included on this claim.

   5. Ins Payments: Displays any payment(s) a payer has paid towards this claim.

   6. Pat Payments: Displays any payment(s) the patient has paid towards the claim (e.g., a copay).

   7. Adjustments: Displays any adjustments the payer has made towards this claim.

   8. Balance: Displays any open balance remaining after insurance and/or patient payments have been applied towards this claim.

   9. Patient Credits: Displays any credit amount available on the patient’s account.

   10. Patient Follow Up Date: Enter a patient follow-up date.

   11. Patient Recall Date: Enter a patient recall date.

   12. Date of Service: Displays the date of the service(s) based on the claim’s procedure codes.

   13. Date Entered: Displays the date this claim was created.

   14. Last Billed Date: Displays the last date this claim was submitted to a payer.

   15. Last Statement: Displays the last date a statement was sent for this claim.

   16. Statements Mailed Count: Displays the number of statements mailed for this claim (this option is only available if the Statement Automation Setting to "Send separate statements for charges per claim" is enabled).

   17. Electronic Statement Count: Displays the number of electronic statements sent for this claim (this option is only available if the Statement Automation Setting to "Send separate statements for charges per claim" is enabled).

   18. Follow Up Date: Enter a follow up date for this claim. Claims with follow up dates can be tracked within the Follow Up Management screen.

       The Follow up date can be automatically populated on a claim based on the payer the claim was billed to. For more information on defaulting follow up dates per payer reference the General Billing Options Help Article.

   19. Copay Remaining: Displays the unpaid copay balance for the claim.

6. Click Save.