Claim Statuses

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    GW - Technical Writer (Edited )

    A claim can have various statuses during its lifetime. Statuses can vary by payer.

    Stage 1 – You create the claim in Dentrix Ascend. Possible status:

    • UNSENT

    Stage 2 – You submit the claim electronically. Possible statuses:

    • QUEUED
    • SENT
    • RESUB (Resubmitted)
    • For a claim without attachments (or if the payer does not accept attachments)
      • RECEIVED – The initial status.
    • For a claim with attachments (if the payer accepts attachments)
      • NEAHOLD (NEA Hold) – The NEA number for the attachments was requested.
      • NEAERROR (NEA Error) – The NEA number was not received.
      • EXTRACTED (In Transit) – The claim was extracted and sent to the clearinghouse.
      • REJECTSV (Rejected by eServices) – The claim did not pass validation upon extraction.

    Stage 3 – Dentrix Ascend sends the claim to the clearinghouse. Possible statuses:

    • ACCEPTED – The clearinghouse received the claim. (If the payer does not provide status updates, this is the final status; ignore stage 4.)
    • REJECTED – The claim failed validation.
    • UNPROCESS (Unprocessable Claim) – The claim could not be processed, which is similar to Rejected.

    Stage 4 – The clearinghouse forwards the claim to the payer. Possible statuses (if the payer provides any status updates):

    • ACCEPT / ACCEPTED
    • REJECT / REJECTED
    • UNPROCESS (Unprocessable Claim)
    • PAID
    • ZEROPAY (Zero Payment) – Zero or no payment.
    • ADDINFO (Additional Information Requested) – Additional is information needed.
    • PENDING
    • SETTLED

    Other possible statuses:

    • PRINTED
    • DELETED
    • VOID (Voided)
    • PAYRECVD (Payment Received)
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