Encounter status
ID | Code | Description | Detailed Description |
93 | IMEHR | Imported | Encounter(s) imported from EHR/Interface |
94 | NEWEN | New Encounter | Newly created encounter, yet to be billed |
95 | CLMIN | SentToPayer | Claim sent to the payer |
96 | RDYTB | ReadyToBill | Encounter is now patient responsibility and statements are generated for the patient |
97 | SETTL | Settled Encounter | Encounter balance has been completely paid |
729 | RTSTP | Ready to Send to Payer | The claim is saved in the system |
1057 | CLILO | Sent to Payer Leave Open | A line item is left open to send an appeal to the payer |
1292 | DRFTE | Draft Encounter | These encounters won't be visible on the UI |
Line Item status
ID | Code | Description | Detail Description |
1059 | IMEHR | Imported | Encounter(s) imported from EHR/Interface |
1060 | NEWEN | New Encounter | The line item is yet to be billed |
1061 | CLMIN | SentToPayer | The claim is sent to the payer for the line item |
1062 | RDYTB | ReadyToBill |
The line item is ready to bill to the patient via a statement
|
1063 | SETTL | Settled Encounter | Line item has been completely paid |
1064 | RTSTP | Ready to Send to Payer | The claim is saved in the system for the line item |
Claim status
ID | Code | Description |
39 | NEWQD | New |
40 | SENTO | Sent Out |
41 | ERROR | Errored |
42 | PAIDO | Paid |
43 | RSOLV | Resolved |
44 | CANCL | Canceled |
509 | CHPSD | Clearing House Passed |
586 | REJET | Rejected |
697 | SRBER | ScrubError |
991 | PRACT |
Payer Accepted |
Claims and encounter definitions
Encounter bucket
Unbilled |
Unbilled (imported or manual) encounters that still need to get worked in the billing system. |
Ready to Send | An encounter that has a claim associated and is ready to send to the payer. |
Billed |
|
Claim Scrubbing (In Progress) |
The Claims Scrubbing tab doesn't need review every day, but a glance is necessary if encounters are in the scrubbing process. Contact RXNT support if you're experiencing delays or issues. |
Claim Scrubbing (Corrections) |
Encounters that have not been created into a Claim because they have corrections that need to get fixed. |
Claims bucket
To Send Electronic |
Saved Claims that need to get sent. |
To Print |
Saved Claims that need to get printed. |
Pending |
Electronic submitted or printed Claims that got sent to the insurance company. |
Resolved |
Claim resolved after posting a payment. |
Canceled | Canceled claims. |
Errored |
Change Healthcare status must get reviewed to determine why Claims were kicked back by the Clearing House. |
Rejected |
Rejected Claims from the Clearing House. |
No Response |
Claims that have not had a response in a certain time frame (it's a company preference under utilities). If you want to resubmit, remail, or contact the insurance company, this is up to you and the practice. |
Denied/Left Open | Claims checked for left open is a workspace to work claim denials. |
All | This is an all bucket that will display all columns. |