Claims

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

The Claims list under its Total, Open, Paid and Denied counts, with Add Filter, Create and the table actions menu above rows of claims showing number, patient, status and charge, each with a selection checkbox

Who Can See It

User only.

The Lifecycle

Status	What it means
Draft	Editable. Findings paint the fields needing attention.
Ready	Passed review, waiting for a batch. Read-only.
Submitted	Left ClaimPod in an export batch, or, for a secondary or tertiary claim the earlier payer forwarded as a crossover, handed on by that payer without a batch.
Rejected	A 277CA, 999 or TA1 acknowledgment refused it before the payer adjudicated it. It waits in Follow-up Claims to be fixed and resent.
Accepted	An acknowledgment from the clearinghouse or the payer accepted it. No money has moved yet.
Denied	The payer refused it. The remittance says why.
Paid	The payer paid and owes nothing more, after its remittance posted or after an overpayment was refunded to it. Any share the patient still owes stays on the claim and is billed to them.
Settled	The 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.
Closed	Finished without more payer money: written off or moved to the patient from a follow-up, combined into another claim, written off from Remittance Review before it was ever filed, or, for a void filing, confirmed by the payer. Nothing more is chased from the payer.
Voided	Withdrawn. It files nothing and takes no new payer payment. A payment the patient already made can stay on the account as a patient credit.

A Ready claim is read-only. It goes back to Draft through Revert to Draft, or on its own when something behind it changes: a review rule, a voided service or a diagnosis on the visit, the patient’s insurance or demographics, or an export that refused it.

Denied, Paid and Settled 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.

Closed is reached by a decision rather than by the money: the Resolution choice on a follow-up item in The Queue Processor, a combine or a write-off in Remittance Review, or the payer confirming a void.

The List

Column	What it shows
Claim #	The claim number
Patient	Who it is for
Status	Where it is in the lifecycle, with a Primary, Secondary or Tertiary chip. A primary claim carries its chip only once it has a secondary. More chips follow: Replaced when a later claim replaced or rebilled it (hover for which), Not Delivered or Not Printed when its batch could not reach the clearinghouse or the printer, and Replace on a frequency 7 correction
Total Charge	What is billed
Filing Date	When it was filed, or a dash
Created	The day the claim was created
Days Waiting	Days since the claim was created, on a Draft, Ready or Rejected claim. Amber at 14 days or more
Filing Deadline	Days left before the payer’s limit

Each row’s menu offers Edit on a draft or View otherwise, Check Claim on a draft, Revert to Draft on a Ready claim, View History, and Delete on a draft.

Search matches the claim number, the External ID, or the patient’s first or last name. What you type in the search box stays out of the page address, so a bookmark or a shared link carries the filters but never the name you searched for. The search is kept while you move around ClaimPod, and cleared when you reload the page or sign out.

A band of counts sits above the list - Total, Open, Paid and Denied - and follows whatever you have searched for. The first two also carry the amount behind the count, which adds up primary claims only, so a balance handed on to a secondary payer is not counted twice.

The filter rail has eight filters:

Filter	What it narrows to
Status	One or more lifecycle statuses, each with its count
Submission	Electronic or Paper, so a paper payer’s claims can be worked as a set
Payer	One or more payers
Payer Type	One or more payer types, such as Medicare, Medicaid or Commercial
Rendering provider	One or more rendering providers
Blocking findings	With blocking findings or Without blocking findings
Service Date	A range of service dates
Created	A range of creation dates

Opening an aging bucket from Analytics lands here filtered to it, with an A/R age chip and, when you came from one payer’s row, a second Payer chip naming that payer.

Create opens Create Claim. Choose the Patient, then one of that patient’s visits under Visit; ClaimPod builds the claim from the visit’s services, exactly as Generate Claim on the visit does. Claim Number reads Auto: leave it blank to take the next number, or type one in your own format; a number another claim already uses is refused under Claim Number. The visit is refused, with the reason under Visit, when it is cancelled, not ready to bill or has no billable services, and when it already has a claim that isn’t voided, for example E4102523 already has CLM-0000001557. Open that claim instead; Create never rebuilds it.

Table actions, the menu beside Create, holds Export…. It downloads the selected claims or every claim matching the filter, with the columns shown or all of them, as a file you can open in Excel.

Bulk Actions

Select rows with their checkboxes to open the bulk bar. When a whole page is selected, a banner offers to select every claim matching the filter, up to 5,000; past that it asks you to narrow the filter. Changing the filter clears the selection.

Action	What it does	When it is greyed
Check	Checks each Draft claim, as Check Claim does on the claim page. A claim that passes moves to Ready	None of the selected claims is a draft
Export…	Opens Export Claims, which counts how many of the selection are ready, how they split between an 837P batch and a CMS-1500 print batch, and how many are left out. Pick a Deliver to Connection for the electronic claims and a Printer for the paper ones; each kind files as its own run	None of the selected claims is Ready
Revert to Draft	Under More. Returns Ready claims to Draft	None of the selected claims is Ready
Edit Fields	Under More. Sets the Submission method on the selected Draft claims	None of the selected claims is a draft
Export Selected	Under More. Downloads the selected rows as a spreadsheet, as Table actions does	Never
Resend	Under More, for a Manager or Administrator; missing otherwise. After a confirmation, voids each Rejected claim, reverses its charge and creates a new draft from the chart	None of the selected claims is Rejected
Resend Unanswered	Under More, for a Manager or Administrator; missing otherwise. Asks Why are you resending them?, then does the same for Submitted claims no remittance has answered. A claim the payer already answered is skipped	None of the selected claims is Submitted
Delete	Under More. After a confirmation, deletes the selected Draft claims and their lines. Their visits and services stay and can generate new claims. A draft carrying money the patient paid is refused until the payment is moved or refunded	None of the selected claims is a draft

A bulk action runs for the whole selection and reports each claim as succeeded, failed or skipped. A claim it does not apply to is skipped with its reason, such as “Still a draft; check it first.” or “Paper claim; it goes in the CMS-1500 print batch.”. The run’s progress opens in a panel you can close while it keeps going, and the finished run is kept under Tasks and Schedules. A filing run links to its batch with Open Batch. Re-checking open claims after a review rule changes is a run ClaimPod starts on its own; it is not on the bar.

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

States

Empty - a client with no claims says No claims found.. Claims are generated from visits, on the visit or with Create; a secondary claim is created from its primary when the primary’s remittance posts, and a tertiary from its secondary the same way, not from a visit.
Counts unavailable - when the figures behind the band cannot be loaded, the whole band disappears rather than standing there reading zero. A zero claim count and an unknown one mean opposite things, so the screen shows neither instead of the wrong one. The list underneath is unaffected: your claims still load, filter and open as usual. Search again or reload the screen to bring the band back.
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.