Tracking the status of CMS 1500 claims

Therapyzen's Claims Dashboard enables you to easily keep track of claims that you have created and submitted, and manage details including statuses, dollar amounts, and reimbursement details. This streamlines the operations of you and your team, as you can quickly sort and filter by status.

You can access the Claims Dashboard by navigating to the Claims area in the main menu. Note that if you are part of an organization, your administrator will need to provide permission such that you can view CMS 1500 claims for yourself and for other members of your organization. 

Search and sorting options on claims dashboard

There may be instances in which you'd like to sort and navigate the CMS 1500 claims that you have created, to take action on some / all of your claims. For example, if you are on the phone with a particular insurance company, you can use this status filter to address all outstanding claims from one particular insurance company.

Therapyzen's claims dashboard allows you to filter by:

• Client name
• Payer
• Service date
• Status 
• Status Date

You may also use the quick search to find specific claims easily

Viewing the Status of Claims

You can view the status of each claim that has been created, as well as keep track of important reimbursement details. You'll also be able to see the number of claims for each status, allowing you to more efficiently keep track of claims. Status Options include:

• Sent: Use this Status if you have sent a claim to your Clearinghouse
• Batched: Use this status after you have included this claim in a batch for export
• Rejected by clearinghouse: Use this status for rejected claims from your clearinghouse (ie. Office Ally) that need to be updated and resubmitted to your clearinghouse 
• Denied by insurance: Use this status if insurance has processed your claim and have denied reimbursement 
• Client Deductible Applies: Use this status if insurance payer has indicated that your client will owe a deductible amount before insurance will reimburse for services. 
• Partially-Paid Use this status if the claim has been reimbursed but there is still a remaining client-owed responsibility 
• Fully-Paid: Use this status if a claim has been processed 100% and there is no remaining client-owed responsibility
• Closed: If you'd like to take no further action on this claim, simply change the status to "Closed" 

Setting Co-Pay, Reimbursement Amount, and Reimbursement Details

You may want to set a co-pay and indicate reimbursement amount for a CMS 1500 claim.  From a client record, navigate to Insurance Info > Primary Insurance  information.  Set co-pay and deductible information there and it will always be displayed on the client record for easy viewing.