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Tracking Claims

Tracking your claims will help prevent denials for exceeding the timely filing guidelines.

Direct Data Entry

Our Quick Tip, How to view Direct Data Entry reports in Online Services, explains how to set up your report preferences and create reports if you use Online Services to submit 1500 claims. Follow the steps in the Quick Tip every time you submit claims and receive a batch number.

EDI Claim Reports

If you or your clearinghouse submit claims as HIPAA-compliant 837 files, we recommend that you retrieve and review your:

  • File Detail Summary Report (277CA Report)
  • Batch and Claim Level Rejection Report (the “Submitter PDF report”)
    • The report will tell you the number of claims that were:
      • Submitted
      • Accepted
      • Rejected and why.
  • Functional Acknowledgement (999 Report)
  • Interchange Acknowledgement (TA1)

For more information on these reports, refer to our direct connection resource, 837 Transactions - Companion Guide for Health Care Claims.

Tips

  • Retain all reports you receive from your electronic claim submission to track receivables and identify potential problems.
  • Resubmit corrected claims electronically. Note: Do not use frequency code 7 for claims adjudication/resubmission of claims that were rejected on the EDI front end. You must resubmit this type of claim as a new-day claim, with claim frequency = 1 (CLM05-3).