Understanding Claim Statuses

Each line item in a claim has a status. Because claims can have multiple line items, they can also have multiple statuses. The statuses of a claim are a collection of all the statuses of its line items.

The status of a claim determines how it can be edited and processed. For example, you cannot bill a claim to a carrier until you set the status of the claim to Ready to Bill.

The following table describes all the claim statuses in AcuityLogic and the actions you can perform on a claim while the claim (or line item) has the specified status.

Status Description Search Claims Actions Claim Detail
Actions Buttons Line Item Actions

Ready to Bill

Claim is ready to be billed to the insurance carrier.

- Claim History

- Preview CMS

- Print CMS Form

- Edit Claim

- On Hold

- Print Lab Order

- Print Receipt

- Add Note

- View Notes

- View Documents

- View Claim

- Edit Claim

- Ready to Bill Patient

- Bill to Carrier

- On Hold

- Generate CMS Form

- Cancel

- Ready to Bill Patient

- Adjustment

On Hold

Claim was placed on hold, either manually or by AcuityLogic. This indicates that the claim needs review and changes.

- Claim History

- Edit Claim

- Print Lab Order

- Print Receipt

- Add Note

- View Notes

- View Documents

- View Claim

- Edit Claim

- Ready to Bill Patient

- Ready to Bill Carrier

- Cancel

- Ready to Bill Patient

- Ready to Bill Carrier

Billed

Claim was billed to the insurance carrier through web billing or printed on a CMS 1500 form.

- Claim History

- Preview CMS

- Print CMS Form

- Reprint CMS Form

- Patient Billing

- Edit Claim

- On Hold

- Write Off

- Print Lab Order

- Print Receipt

- Add Note

- View Notes

- View Document

- Copy Claim

- View Claim

- Edit Claim

- Ready to Bill Patient

- Write Off

- On Hold

- Generate CMS Form

- Cancel

- Ready to Bill Patient

- Adjustment

- Write Off

Fully Paid

Claim was billed and paid in full.

- Claim History

- Edit Claim

- Write Off

- Print Lab Order

- Print Receipt

- Add Note

- View Notes

- View Documents

- Copy Claim

- View Claim

- Edit Claim

- Write Off

- Adjustment

- Write Off

Timed Out

Claim has had no activity for 60 days.

- Claim History

- Preview CMS

- Edit Claim

- Write Off

- Print Lab Order

- Print Receipt

- Add Note

- View Notes

- View Documents

- Copy Claim

- View Claim

- Edit Claim

- Ready to Bill Patient

- Ready to Bill Carrier

- Write Off

- Ready to Bill Patient

- Ready to Bill Carrier

- Write Off

Underpaid

Claim was underpaid and needs action.

- Claim History

- Preview CMS

- Patient Billing

- Edit Claim

- Write Off

- Print Lab Order

- Print Receipt

- Add Note

- View Notes

- View Documents

- Copy Claim

- View Claim

- Edit Claim

- Ready to Bill Patient

- Ready to Bill Carrier

- Write Off

- Cancel

- Ready to Bill Patient

- Ready to Bill Carrier

- Write Off

Overpaid

Claim was overpaid and needs action.

- Claim History

- Edit Claim

- Write Off

- Print Lab Order

- Print Receipt

- Add Note

- View Notes

- View Documents

- Copy Claim

- View Claim

- Edit Claim

- Ready to Bill Patient

- Ready to Bill Carrier

- Write Off

- Adjustment

- Cancel

- Ready to Bill Patient

- Ready to Bill Carrier

- Adjustment

- Write Off

Rejected

Claim was rejected by the insurance carrier (for example, for invalid provider information).

- Claim History

- Preview CMS

- Edit Claim

- Write Off

- Print Lab Order

- Print Receipt

- Add Note

- View Notes

- View Documents

- Copy Claim

- View Claim

- Edit Claim

- Ready to Bill Patient

- Ready to Bill Carrier

- Write Off

- Cancel

- Ready to Bill Patient

- Ready to Bill Carrier

- Write Off

Canceled

Claim was canceled and may require action.

- Claim History

- Preview CMS

- Print Lab Order

- Print Receipt

- Add Note

- View Notes

- View Documents

- Copy Claim

- View Claim

- None

Ready to Bill Patient

Claim is ready to bill to the patient. If the carrier rejects a claim and gives a reason similar to “patient not eligible for benefits,” you can change the status to Ready to Bill Patient.

- Claim History

- Preview CMS

- Generate Patient Letter

- Edit Claim

- On Hold

- Write Off

- Print Lab Order

- Print Receipt

- Add Note

- View Notes

- View Documents

- View Claim

- Edit Claim

- Ready to Bill Carrier

- Write Off

- On Hold

- Generate Patient Letter

- Cancel

- Ready to Bill Carrier

- Adjustment

- Write Off

Billed to Patient

Claim was billed to patient and is awaiting action.

- Claim History

- Preview CMS

- Generate Patient Letter

- Edit Claim

- On Hold

- Write Off

- Print Lab Order

- Print Receipt

- Add Note

- View Notes

- View Documents

- Copy Claim

- View Claim

- Edit Claim

- Ready to Bill Carrier

- Send to Collections

- Write Off

- On Hold

- Generate Patient Letter

- Cancel

- Ready to Bill Carrier

- Adjustment

- Write Off

Written Off

All or part of the receivable for the claim was written off.

- Claim History

- Preview CMS

- Print CMS Form

- Edit Claim

- Write Off

- Print Lab Order

- Print Receipt

- Add Note

- View Notes

- View Documents

- Copy Claim

- View Claim

- Edit Claim

- Ready to Bill Patient

- Ready to Bill Carrier

- Write Off

- Generate CMS Form

- Ready to Bill Patient

- Ready to Bill Carrier

- Write Off

Collections

Claim was sent to collections.

- Claim History

- Preview CMS

- Print Lab Order

- Print Receipt

- Add Note

- View Notes

- View Documents

- Copy Claim

- View Claim

- None

Non Receivable

Carrier will not be reimbursed for at least one item on the claim.

- Claim History

- Preview CMS

- Edit Claim

- Print Lab Order

- Print Receipt

- Add Note

- View Notes

- View Documents

- Copy Claim

- View Claim

- Edit Claim

- Cancel

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