Suspending Claims

A claim is placed in a Suspended status anytime:

  • A  problem exists on a claim that needs to be resolved
  • Additional work needs to be done
  • The claim needs to be verified one last time

A claim can be suspended automatically or manually. For example, the system will place a claim in suspension when you click Suspend for review or you manually suspend a claim if you stop sending patient invoices.

Change the reason for the suspension

As you work a claim, the reason for a suspension can change. Use the Claim page to update the reason.

  1. On the Claim page, click the pencil icon (edit) next to the status.
  2. Scroll down the suspended reason list and select a reason.
  3. Click Save. The system will change the status/status reason of the claim to the one you selected.

Remove the suspended status

When a claim is in a suspended state, you have three options:

  1. Change the reason: Click the edit icon next to the status/reason to change the reason for suspension.
  2. Submit the claim: The reason for the suspension was resolved enabling you to submit the claim to the clearinghouse.
  3. Cancel the claim: The claim is no longer valid and needs to be canceled.

Suspending a claim that is queued for submission

If a claim is queued for submission, you can suspend it by clicking the Suspend button on the right side. This action will only suspend this claim - not the entire account.