Biller Defined Claims

Biller Defined claims are claims that have been routed to a custom biller defined status. This could have been done manually or could have been done automatically based on CARC code settings, payment settings, or company settings. These claims have been routed to a specific category purposefully and should be reviewed and addressed according to the category.


  1. Click the magnifying glass to open Billing Query.
  2. Double click the claim to open the Edit Claim screen. Review the claim to determine the reason the claim is in the biller defined status. 
    • Review the Comments
    • Review the Activity Log
    • Review the Human Readable ERA

  3. Make any updates to the claim as necessary and set the claim status to Ready to Send
  4. The claim can now be sent/resent or it will be included when claims in Ready for Processing are processed.