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Claims

Every claim through its lifecycle, and the batches that file them.

The Claims list showing each claim's number, patient, status and charge amount

User only.

StatusWhat it means
DraftEditable. Findings paint the fields needing attention.
ReadyPassed review, waiting for a batch. Read-only.
SubmittedLeft ClaimPod in an export batch.
AcceptedThe payer acknowledged it. No money has moved yet.
DeniedThe payer refused it. The remittance says why.
PaidA remittance posted against it.
SettledThe payer processed it and nothing is owed by anyone, without money moving on this claim. The normal outcome for capitated care, where the contract already paid for it.
VoidedWithdrawn. It files nothing and accepts no payment.

Editing a Ready claim or its source visit returns it to Draft. That is the intended way to change one.

The last four are reached by the money, not by you. A remittance that is still held for review moves nothing - the status changes only when the posting lands. Reverse a posted remittance and the claim steps back to where it was.

ColumnWhat it shows
Claim #The claim number
PatientWho it is for
StatusWhere it is in the lifecycle
Total ChargeWhat is billed
Filing DateWhen it was filed, or a dash
Filing DeadlineDays left before the payer’s limit

The claim itself has its own page: The Claim Page.

  • Empty - a client with no claims says so; claims arrive from visits, never by hand.
  • Blocked - without the claims module the screen is not in the sidebar, and a saved link to it says the module is not part of your plan.

Related: The Claim Page · Claim Exports · Check and Fix a Claim · Export Ready Claims · Analytics · A Claim Will Not File