Claims in the No Response After 7 Days category are claims that have been sent out but an acknowledgement response was never received from the clearinghouse/payer. In some cases this may be acceptable but in many cases this could mean the claims never made it to their intended destination. These claims should be reviewed by category to determine if they should be resubmitted or not. One example would be that claims in Sent, Paper could take much longer for a response and can be ignored while Sent, Electronic should have a response much quicker.
Workflow
- Click the magnifying glass to open Billing Query.
- Double click the claim to open the Edit Claim screen. Review the claim to determine if the claim needs to be resent.
- Comments can help you identify if the claim made it to the clearinghouse
- Submission History (History Drop down and then Submission) can also help you with finding clearinghouse message regarding the claim.
- Comments can help you identify if the claim made it to the clearinghouse
If the claim has made it to the clearinghouse and you see clearinghouse response messages as above then then the claim is in good standing. It will be removed from the No Response After 7 Days category as soon as payment is received.
If the claim does not have any clearinghouse or payer messages then it should be resent.
- On the claim screen, change the status back to Ready to Send.
- The claim can now be resent or it will be included when claims in Ready for Processing are processed.
