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Santa Rosa, CA  95407
Phone: (800) 763-8484

Claim Tracking and Management

ClaimRemedi’s claim tracking and management module provides complete claim tracking from claim submission through claim adjudication, and can be used to:

  • Provide proof of timely filing to payers.
  • Identify and track rejected or denied claims along with the reason for rejection/denial as well as assign these claims for billing or clinical staff follow-up depending on what is needed.
  • Identify claims “missing in action” or “lost” by the payer.
  • Perform electronic claim status inquiries to payers.
  • Monitor follow-up by your billing staff — errors corrected, errors overridden, completion of follow-up items, etc.

The view claim feature displays all payer responses for a claim, from claim submission through adjudication in easy to understand messages that don’t require additional interpretation.

Staff assignments and notes for follow-up can be added as needed. These can either be done on an individual claim basis or to groups of claims with a single entry.

An auto close feature automatically “closes” all claims that have been paid or for which the last response from a payer indicates that the claim has been accepted and no further electronic responses are expected. This eliminates the need for your staff to spend time manually closing claims that should be closed. Closed claims can always be accessed and included in any query, as needed.

You can retrieve any single claim or group of claims meeting any combination of selection criteria: staff member assigned to claim; claim status (received by payer, accepted, rejected, paid, denied, etc.); date uploaded, date of payer response, date of service; payer; patient name & account; provider; and batch file.

An advanced search feature provides access to all 837 X12 claim fields (procedure code, diagnosis, condition code, etc.) for both professional and institutional claims. Claim selection criteria for common searches can be stored as search templates and retrieved for future use.

All query results can be exported to a spreadsheet for your own further analysis.

Audit reports itemizing all payer responses, assignments and notes — the who, what and when for either a single claim or a group of claims can be readily printed at any time.