Resolve Claims Stuck in Pending Status

Permissions! Users need to be in the Payroll & Billing group and have the the Submission Report permission in the Permission Groups page.

Occasionally claims get stuck in a Pending billing status after you’ve marked them Ready to Bill. Claims are held in pending status if required information is missing.

Identify claims stuck in pending status:

1. Open the Submission Report:
   
2. Select Yes for Ready to Bill
3. Click Pending for Billing Status
4. Add the end date as yesterday's date
5. Filter by Ready to Bill Date
   
6. Click Update View

Run this report weekly to ensure all claims are submitted.

Resolve claims in pending status:

1. Enter or update the following items:
   • Patient demographics in the Client Info
     • For example, Address, Birthday, and ICD 10 Diagnosis
   • The Subscriber Number in the InsuranceNumbers link
   • The payer in the InsuranceNumbers link
   • The Total Billable field in the Submission Report 
   • The service does not match an active insurance number entry.
2. Make sure the claim line is marked Ready to Bill