Line item and Claim Status Definitions

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 the patient's responsibility and statements are generated for the patient
97 SETTL Settled Encounter The 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 The 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

Payer Accepted


Claims and encounter definitions

Encounter bucket


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.
  •  An encounter was sent to the insurance company, and it is ready to bill the patient.
  • Settled Encounters
Claim Scrubbing (In Progress)

The Claims Scrubbing tab doesn't need reviewed 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 be fixed. 

Claims bucket

To Send Electronic

Claims that need to be submitted electronically.
To Print

Claims that need to be printed and sent out.


Claims sent electronically or printed that were sent to the insurance company. 


Claims that have been resolved. 

Canceled  Canceled claims.

Change Healthcare status must be reviewed to determine why the Clearing House kicked back claims.  


Rejected claims from the clearing house or payer.

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, email, or contact the insurance company, this is up to you and the practice. 

Denied/Left Open Claims that have been denied or left open for review. 
All This is an all-bucket that will display all columns.



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