Review an Import Row
A row stops at import review when ClaimPod cannot decide something on its own. Until you resolve it, nothing from that row reaches your live data, except where a problem holds only part of the row (see Problems Worth Knowing).
Resolve the Row
Section titled “Resolve the Row”Every decision on the row is applied when you select Complete. Until then nothing is written except the field corrections you save.
- In the sidebar, select Work Queues.
- In the list of queues, open the Import Review queue for the day the file imported.
- In the queue list, select a row. The item opens on its key facts: status, file row, mapping and the charges in the file. Below them is a section per record the row has data or problems for - Patient, Visit, Services, Insurance, Claim and Payment - as cards on a wide screen and tabs on a narrower one. Each section counts its open problems.
- In the Problems tab on the right, read each problem. Problems are grouped as Errors, Warnings and Decided; Decided starts folded. Select a problem to open the field it concerns. A problem that Doesn’t block is for information: the row imports, but the claim cannot be billed until someone fills in what is missing.
- In the Patient section, open Decision and choose how to resolve the patient. Each match candidate shows its match percentage and a one-line summary, such as “Same date of birth and gender; name and MRN differ”; hover it for the full comparison. Search for any other patient, or choose Create new patient. A patient the import already settled cannot be linked elsewhere.
- Optional: In the Patient section, under Decision, select the checkbox that reads “Also link rows …, which have the same …”. It appears when other rows in the file carry the same patient, and links up to 50 of them. A linked row with nothing else to decide closes with this one.
- In the Visit, Insurance and Claim sections, open Decision and choose a record for each. The visit and claim lists show only the chosen patient’s records, so decide the patient first. When ClaimPod found nothing to link, the choice already reads as creating the record.
- In the Services section, open the Decision beside each service and choose to link it, create it, or ignore it. Ignoring a service leaves it out and keeps the rest of the row.
- In any section, correct a field the file got wrong. A Value Not Allowed problem names the value received and what the field accepts; see What a Field Accepts.
- In the bar at the bottom, select Save Changes. Saving checks the fields again, so a corrected problem clears. If someone else changed the row since you opened it, the save is refused and Reload appears; see A Save Was Refused.
- In the bar at the bottom, with Import Row chosen in Resolution, select Complete. The Changes tab lists what Complete will do. Complete is refused while a blocking problem remains, and any problem it finds is added to Problems. It is also refused with “Another biller is working this item.” or “This item is assigned to another biller.” while someone else holds the item.
Result: the row promotes into patients, visits and services as though it had imported cleanly. Linking the row to a patient by hand leaves that patient’s chart details as they were.
Decisions stay with their rows while you move between items in the queue. Leaving the queue with unsaved edits or decisions asks first, because they are discarded.
Map an Unknown Code
Section titled “Map an Unknown Code”A problem on a field such as a payer ID can mean the file used a code ClaimPod has not mapped yet. Your decision applies to that code for the whole mapping, not only this row.
- In the Problems tab, select the unknown code’s problem.
The field opens with a decision under it named for the code, such as
Map 61101 To. - In that decision, choose the payer, provider or location the code stands for.
- Optional: In that decision, choose “Create new payer” (or provider, or location) instead, and fill in the fields.
- In the bar at the bottom, select Complete. Other rows in the file that were waiting only on the same code close with this one.
Import an Unknown CPT or ICD-10 Code
Section titled “Import an Unknown CPT or ICD-10 Code”Correct an unknown code when the file got it wrong. When the code is valid and only newer than ClaimPod’s code set, import it anyway.
- In the Problems tab, select the Unknown CPT or Unknown ICD-10 problem.
- In the section that opens, select Import Anyway….
- In Note, enter why the code is valid.
- Select Import Anyway. The problem moves to Decided and reads “Imported anyway by” your name and the note.
- In the bar at the bottom, select Complete.
An unknown diagnosis can only be imported anyway or rejected with the row. On an import set to send charges to Coding Review, unknown codes and missing diagnoses wait there instead of in Import Review.
Price an Unpriced Service
Section titled “Price an Unpriced Service”The visit cannot be billed until an unpriced service has a charge.
- In the Services section, enter the amount in the service’s Charge. The problem moves to Decided; open the folded Decided group to see it.
- In the bar at the bottom, select Complete. The charge is saved on the service as the row imports.
Problems Worth Knowing
Section titled “Problems Worth Knowing”| Problem | What happens |
|---|---|
| Unpriced Service | The service is already on its visit and waits only for a charge |
| Unknown CPT / Unknown ICD-10 | Only that service or diagnosis is held; the patient and visit import |
| $0.00 Charge, No Diagnosis, Character Replaced, Unknown Place of Service | A notice. It does not hold the row |
| Missing Required Field on the admit date | The row waits. When a later import brings the visit with its admit date, the row imports itself and its item completes |
| Unknown Payer | The payer ID matches no insurance plan, so the row’s coverage was not imported and its visit waits for the payer |
| Visit on Another Chart | The visit number already belongs to another patient’s chart, so the row was not attached to it |
What a Field Accepts
Section titled “What a Field Accepts”| Field | Accepts |
|---|---|
| Gender, marital status, diagnosis type | Only ClaimPod’s own values |
| ZIP code | 5 or 9 digits, saved as digits only |
| State | A two-letter US code, saved in capitals |
| Location code | At most 20 characters |
| Claim number | Anything except *, ~, ^ and : |
| Date of birth | A date not in the future; a future one is held as Invalid Date |
Reject a Row
Section titled “Reject a Row”Reject the row when nothing in it should reach your data. The decisions on its sections are ignored.
- In the bar at the bottom, open Resolution and choose Reject Row. The records dim under a banner saying the row will be rejected.
- In Why this row won’t be imported, enter the reason. The reason needs 10 to 500 characters.
- In the bar at the bottom, select Complete.
- In the bar at the bottom, confirm with Reject Row. The row is rejected and the next item opens.
Why a Row Stops at All
Section titled “Why a Row Stops at All”ClaimPod promotes only what it can resolve alone, so a row you have not seen never becomes a silent bad record. That is the trade the claim loop makes: fewer records to trust blindly, some rows to decide. If a source suddenly stops every row, see An Import or Queue Is Stuck.
Related: The Queue Processor · Import Batches · Work a Queue Item · The Claim Loop