Real-Time Claim Status (RTCS) electronically gives immediate feedback on Claims that have been Payer Accepted.
- The Job Scheduler can be used to check the Payer Claims Status automatically for outstanding Payer Accepted Claims.
- Set the number of days that the Payer Response is valid using the System Setting:
Job Scheduler Criteria
Admin > Job Scheduler > Add
- Run Function: Select Payer Claim Status from the dropdown.
- Current Claim Status: Select the Encounter Claim Status(es) to be included in the scheduled job.
- This is a Multi-select field (More than one Status can be selected)
- The field defaults to PA.
- Role: Select an option from the dropdown if applicable.
- All (Default)
- Primary
- Secondary
- Tertiary
- You may want to run the Claim Status check for specific Insurance(s), Facility(s), Insurance Reporting Group(s), or Facility Reporting Group(s) (Optional)
- Select options from the dropdowns on each field.
- These fields are multi-select.
- Check After ____ Days: This setting determines when the Claim Status Job should begin.
- If the Payer(s) selected for this Job usually pay within 14 days, select 14 (Days) in the dropdown.
- The Job will begin on the 15th day.
- Send to Worklist, After: The Job will continue to check the Claim Status until it reaches the After Days threshold selected from the After dropdown list.
- After the specified number of days, the Send to Worklist setting will be used to add the Claim to the Worklist selected in the dropdown.
- Update Claim Status if Paid/Allowed: Select the Claim Status for the Encounter after the RTCS response shows that the Claim has been adjudicated and Paid.
- Does not include a $0.00 Allowed Amount.
- Update Claim Status if Denied: If the RTCS response shows that the Claim has been Adjudicated and Denied, the Encounter Claim Status will update to the option selected in the dropdown.
- Pattern: Set a schedule for how often the job should run.
- Range: Select the timeframe for the job to run.
- Enter the Start Date.
- Enter the Time for the job to run.
- Select No End Date.
- Select Save [F2].
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