Overview

Claims that require attention are grouped in the Error bucket in Billing Worklist. These claims may have failed validation or submission.

This article explains how to review the error details, correct the claim information, and continue processing the claim.

Reviewing Claim Errors

Important: The Claims table displays claim information after configured payer rules are applied during claim generation. If a field such as Rendering Provider differs from the clinical note, check whether a payer rule accounts for the difference before making changes. Use the Clinician filter to find claims by the clinician who performed the service or the Signed By filter to find claims by the note's signer.

1. Go to Dashboard > Billing Worklist > Claims.
2. Select the Error bucket.
3. Select the claim you want to review.
4. Select Edit Claim.

The Edit Claim screen displays the validation errors that need to be addressed.

Fields with validation errors are highlighted to help you identify the information that needs to be corrected.

You can also download the claims as a CSV file to review validation error details.

Fixing Validation Errors

After reviewing the error details:

1. Update the information identified in the validation message.
2. Select Validate to check the claim again.
3. If additional errors are identified, correct them and select Validate again.
4. Once the claim passes validation, continue with the claim submission process.

If the information identified in the error is not available on the Edit Claim screen, update it in the appropriate section of the client's account and then process the claim again.

Fixing Submission Errors

A claim can move to the Error bucket if submission fails.

For primary, secondary, and tertiary claims, submission failures are identified by the following statuses:

• Submission Failed
• Ready for Secondary - Submission Failed
  
• Ready for Tertiary - Submission Failed
  

After Fixing an Error

The next step depends on the type of error and the claim's current status.

• For a validation error, correct the required information and validate the claim again before continuing with submission.
• For a submission error, correct the reported issue and submit the claim again.
  

FAQs

Why is my claim in the Error bucket?
The claim is in the Error bucket because it has a validation or submission failure that requires attention.

How do I find what needs to be corrected?
Open the claim from the Error bucket and select Edit Claim. Review the validation or submission error details to identify the information that needs to be corrected.

What if I cannot find the field mentioned in the error on the Edit Claim screen?
Update the information in the appropriate section of the client's account and then process the claim again.

Can I review validation errors without opening each claim?
Yes. You can download the claims as a CSV file to review the validation error details.