Encounter by Status FAQs
Claims are stuck in the Ready for Submission Status
The most common reason is that the Reference Batch is not closed.
Check the Reference Batch to see if it is closed.
If it is still open, it must be closed before the Claim will be batched.
On the Encounter Dashboard, the Padlock icon in the Charge panel should display as locked.
Are all Tags resolved that may be holding the Claim?
Resolve Tags
The Claim is Ready for Submission/Resubmission on the Encounter by Status Panel, but did not batch.
The Reference Batch is probably not closed.
The claim is in the Open Reference Batch items on the Claims Submission Queue panel.
Close the Reference Batch
Encounter has a Zero balance and the Claim Status is not IP06 (Ready for Submission Zero Balance).
- By Default, the System will not batch Zero-Balance Encounters.
- To submit the Claim, override the Default by changing the Claim Status to Ready for Submission/Resubmission.
- The Claim Status will show on the Encounter as Ready for Submission Zero Balance.
Check the Insurance Library for:
- Form Type: Is it marked for Electronic Submission?
- Payer ID: Is the Payer ID missing?
Claims Statuses that are eligible to be uploaded or submitted to the Clearinghouse
IP03: READY FOR SUBMISSION
IP04: READY FOR RESUBMISSION
IP06: READY FOR SUBMISSION ZERO BALANCE
This status indicates that the User has set an Encounter to resubmit that currently has a zero balance.
HCFA (Paper Claim) Box 33 is Blank
- From Libraries on the Left Side Menu, select Billing/Pay To Location. The Block Address must be populated. Select Copy to populate the Block Address.
- Check that the Facility has the Block Address selected.
- Check that no ID or Cross Codes are setup on the Insurance or Provider to intentionally leave this area blank.
Related Articles
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