What do the different claim statuses mean?

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James Moser

December 31, 2014 15:24

An office asked us what the different claim statuses mean on Ascend?

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  Kenneth Rhodes August 25, 2017 17:29

  Claims that are in a Queued status can be deleted without causing a duplicate issue. These claims have not been extracted for submission yet.

  All other claim status relate to claims that have been extracted and will be forwarded to the insurance payor. These claims can be deleted, but if they are created again and submitted without changes, then there could be duplicate claim issue.

  A claim that is in an NEA Hold status has been extracted for submission, there is an attachment, so the attachment was forwarded to NEA and we are waiting to receive the NEA # so that it can be included on the claim sent to the payor. 

   

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  Kathleen January 02, 2015 14:47

  The statuses mean what their definition is?  Create, Unsent, Sent, Resolved first then under Sent claims you have Printed, Queued, Sent, Settled, Accepted, etc.  or is the status messages like 016 Claim/encounter has been forwarded to entity or entity acknowledges receipt of claim/encounter?  Not sure which status as there are a few.  If it is the last statuses I've written, then the ones I've put are pretty self explanatory, if it's a different status in that location then it is probably best to call the insurance company to inquire on the claim in question as they may need more information or the claim may need to be printed and mailed as the insurance company may not accept e-claims.  Hope that helps.  

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  James Moser January 26, 2015 16:25

  UNSENT- Claim has not been submitted yet.

  SENT- Been sent to the clearinghouse.

  QUEUED- In process of being sent. Should rarely be seen now with update. After you submit the claim it will go straight into a sent status.

  NEA HOLD- This status means that Dentrix Ascend is waiting for the NEA number from NEA before forwarding the claim to the insurance.  When a claim is sent with an accompanying attachment, Dentrix Ascend will forward the attachment to NEA first before the claim is forwarded to the insurance company.   NEA will then send Dentrix Ascend a NEA number to place in the claim's remarks for unusual services field. Once the NEA number is on the claim in the database, we will then forward the claim to the clearinghouse.   A claim should only be in a NEAHOLD status for a day or two at most. If a claim is in NEAHOLD status for longer than 48 hours, please contact support.

  ACCEPTED-

  PAID-

  PRINTED-

   

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  Chris Christley May 19, 2017 16:49

  Settled- This is just another way of saying that the insurance excepted the claim.

  Unprocessable- This is another way of saying the claim was rejected.

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  Renesha August 25, 2017 17:11

  If a claim (or Pre-D) was just submitted and says NEA HOLD or QUEUED, if we forgot to attach something, how long do we have to delete it without causing multiple claims for same thing? If it is within a few minutes, are we safe to delete, attach everything and resubmit?

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  Chris Christley December 21, 2017 20:35

  Gina, I am sorry that I didn't see your comment until now. I must not have selected to follow the article at the time.

  • The queued status normally can take a few seconds to possibly a few minutes, but there is not a specific time frame.
  • The NEA hold might take a few min while it's waiting to get an NEA number for the attachments. 
  • While the status is showing either queued & NEA hold status then you can delete the claim without worrying about it being sent.
  • If you see these status's showing for longer than 48 hours then please contact support.

  By this point you may already have received your answer, but I hope this is helpful to you.

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  Larry Hatfield May 28, 2019 19:58

  Chris Christley

  When you say "Settled- This is just another way of saying that the insurance accepted the claim."

  Do you mean that the claim is 'left out of consideration' or do you mean that it is ACCEPTED for processing?

   

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  Chris Christley May 28, 2019 22:21

  You would view it as an accepted claim by the insurance. Sorry about the incorrect spelling there.

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  Jeremy Jackson November 14, 2019 22:14

  the in transit status on the sent claims report is another intermediate status between queued and sent, ( it will show extracted on the claim status notes

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  Blacka Pittman June 19, 2020 01:34

  I was told my claim is in C status what does that mean

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