DocStation

Claim reconciliation is important, and in some cases, it might be necessary to manually update the status of a claim. The most likely case is when the <a href="https://help.docstation.co/en/articles/9016524-what-is-an-electronic-remittance-advice-era-and-why-are-they-important">Electronic Remittance Advice (ERA)</a> is not enrolled for the payer to which the claim was submitted. The manual status update feature will enable users to reconcile claims on DocStation in the absence of the ERA, or other technical limitations.

A claim can be transitioned to Paid or Denied, <a href="https://help.docstation.co/en/articles/9012659-finalize-claims">as well as Finalized</a>, from any prior lifecycle status. The same Update status option can be utilized if a claim is incorrectly transitioned to one of these adjudicated statuses, or if the wrong dollar amount is applied to any field in the form. Simply follow the workflow below. 

The Update Status feature allows you to do this easily. Here's how:

Locate the claim you want to update in the claim table and click on the meatball menu. Underneath, you will find 

Select the appropriate claim status. At this stage, you can mark the claim as either "Paid" or "Denied", as well as "finalized" in each status.

After confirming your selection, a form will appear. Fill out the form to the best of your knowledge:

1. If Paid is selected, provide the following information (all fields are optional):
   1. Paid date
   2. Check number
   3. Claim number
   4. Insurance Allowed Amount
   5. Insurance Paid Amount
   6. Patient Responsibility Amount
2. If Denied is selected, provide the following information (all fields are optional):
   1. Denied date
   2. Claim number
   3. Insurance Allowed Amount
   4. Insurance Paid Amount
   5. Patient Responsibility
   6. Denial reason 

1. Locate the claim you want to update in the claim table and click on the meatball menu. Underneath, you will find 
2. Select the option "Update status". 
3. Select the appropriate claim status. At this stage, you can mark the claim as either "Paid" or "Denied", as well as "finalized" in each status.
4. After confirming your selection, a form will appear. Fill out the form to the best of your knowledge:
   1. If Paid is selected, provide the following information (all fields are optional):
      1. Paid date
      2. Check number
      3. Claim number
      4. Insurance Allowed Amount
      5. Insurance Paid Amount
      6. Patient Responsibility Amount
   2. If Denied is selected, provide the following information (all fields are optional):
      1. Denied date
      2. Claim number
      3. Insurance Allowed Amount
      4. Insurance Paid Amount
      5. Patient Responsibility
      6. Denial reason 
5. Save the selections.

The claim will transition to the selected status, showing the details entered, and the subscription usage will be invoiced accordingly.

How to Manually Update Claim Statuses