Pending Claims overview

The Pending Claims area of the Batch Insurance Payment Entry dialog box provides you with a lot of flexibility. From the Pending Claims area you can do the following:

·        Select ERAs

·        Split primary claims

·        Edit claims

·        View the ERAs in the Document Center

·        Post all pending claims

The Pending Claims list consists of 11 columns:

·        Date - Shows the date the insurance claim was sent or created.

·        Subscriber Name - Shows the name of the subscriber attached to either the insurance or the ERA claim.

·        Subscriber ID - Shows the subscriber’s ID attached to either the insurance or the ERA claim.

·        Patient Name - Shows the name of the patient attached to either the insurance or the ERA claim.

·        Birth - Shows the birth date of the patient attached to the insurance claim.

·        Pri/Sec - Shows whether a Dentrix claim is primary or secondary and has been paid, modified, or not found.

·        Pri Pmt or Sec Pmt - Indicates the claim has not been paid.

·        Pri Pmt ++ or Sec Pmt ++ - Indicates the claim has been paid.

·        Pri Adj or Sec Adj - Indicates the claim has been modified.

·        ? Pmt or ? Adj - Indicates or an adjustment, respectively, cannot be found.

·        eStatus - Appears blank for all listed claims when you select check payment type. If you select electronic payment type, shows the status of an ERA:

·        Not Found - A Dentrix claim cannot be found for the ERA claim.

·        Invalid - The ERA claim is for a primary or secondary adjustment, and the Dentrix claim for the ERA claim has not been paid.

·        OK - Post - The ERA claim and its corresponding Dentrix claim are in the database.

·        Billed Amt - Shows the total of the Dentrix claim.

·        Subm Amt - Shows ERA claim charge amount for the ERA claim. If the amounts in the Billed Amt and Subm Amt columns differ, the amounts appear in red.

·        Est Ins - Shows an estimate of the insurance payment for the procedure.

·        Paid/Adj - Shows the total of the claim less any adjustments that you applied. Appears blank for all listed claims when you select check payment type.

·        Sec - Indicates whether a patient's secondary insurance is attached to the claim.