Status | Description |
IB-WO | Initial Billing – Wrote Off / Wrote off |
RB-NW | Re-bill –NeW – Used to resend claim with no ICN |
IB-RJ | Initial Billing – ReJected / Most likely demographic or Phy issue. Rejected before entering Inc Co system |
RB-Go | Re-Bill – Go / Re-bill claim with ICN |
RB-BT | Re-Bill – Billing Table / Waiting in our Billing. Call Mike if billing is currently running |
RB-WT | Re-Bill – WaiT / Waiting for Insurance Cos Billing |
RB-CP | Re-Bill – ComPlete – most likely paid |
RB-AN | Re-Bill – Attention Needed / Claim Issue after re-billing |
RB-SWO | Re-Bill – Suggest Write Off / Suggested Write Off |
RB-WO | Re-Bill –Wrote Off / Wrote Off |
RB-NW | Re-Bill –NeW – Rebill claim with NO ICN |
RB-RJ | Re-Bill –ReJected / Most likely demographic or Phy issue. Rejected before entering Ins Co system |
DN-CP | DeNied – ComPlete / Good Denial Found |
NP-AN | No Payment – Attention Needed |
PP-AN | Partial Payment – Attention Needed |
OP-AN | Over Payment – Attention Needed |
PP-CP | Partial Paid Complete – balance is patient responsibility |
VD-Go | VoiD – Go /Send to Void Claim |
VD-BT | VoiD Billing Table – Waiting in our Billing |
VD-WT | VoiD WaiT – Waiting for Insurance Cos Billing |
VD-AN | VoiD Attention Needed – problem review order |
FP-CP | Fully Paid – ComPlete |
- If you find that a status is incorrect – such as an order is fully paid, but the status is NP-AN (No Payment – Attention Needed) see your supervisor because he/she has the ability to change the status.
- This section also has the ICN number associated with the procedure and the insurance. If the ICN is incorrect your supervisor has the ability to update the information. This will be addressed during the discussion for re- billing s claim.
5. In Sent / Received
- This section shows you the submission to insurance and response from the insurance.
- Here you will be able to tell when the claim was sent to what insurance and what if any response we have received.
- Order ID – The ID of the order
- Date of Service – this is the Date of Service
- Ins Plan – Payer Name – this is the name we either billed to or the name we received a response from when we billed the claim. The name we receive does not always match our Group Description. If you see a Issue related to Group Description it is usually because the name we received on the payment file is not on our Possible Payers List, in this situation it will appear red in the Ins Plan – Payer Name column. Contact your supervisor to add the name to the Possible Payers Table.
- ClaimAmt – This is the amount billed for the procedure – if it is green that means that it has been paid.
- HCPCS – The procedure that was billed
- Units – the number or items billed, quantity
- CreateDate – the date the claim was sent to that insurance.
- ClaimReference – the ICN Insurance Claim Number – number assigned by the insurance company. You must have this number in order to do re-bills for adjustment or voids.
- AdjustmentReason01 – the reason code associated with the procedure sent by the insurance. If you hover, with your mouse, over the code an explanation should appear. If it does not contact your supervisor they can add the reason to the table.
- AdjustmentReason02 – the reason code associated with the procedure sent by the insurance. If you hover, with your mouse, over the code an explanation should appear. If it does not contact your supervisor they can add the reason to the table.
- AdjustmentAmount01 – the amount that was adjusted for reason 1. This adjustment could be related to exceeds the free schedule or a sequestration .
- AdjustmentAmount02 – the amount that was adjusted for reason 2. This adjustment could be related to a copay or deductible.
- Transaction Type – This provides you with the method the information was received.
- 837 – Electronically sent claim
- 835 – Electronically received remittance
- TransactionFile – the name of the file that contains the claim that was either sent or received. It can either be an electronically sent or received file or it can be a scanned paper document. If it is an 835 file and you would like to see more detailed information about the claim you can retrieve the file using Easy Remit and importing the file from it’s designated location. If it is pointing towards a paper EOB you can retrieve the file by following the path.
- CheckNumber – this is the reference number for the remittance. It can either be a check and EFT or a Trace/Reference number.
- TransactionID – Unique identifier generated by the system.