Real-Time Claim Status

Real-Time Claim Status


Real-Time Claim Status

*This is a Premium Add-on feature.

A Claim can appear to be Payer Accepted, but the Claim has not been adjudicated. 

The manual workflow to obtain a status on the Claim can be very time-consuming. 

  • Real-Time Claim Status (RTCS) is an electronic method of getting an immediate Claim Status update from the Payer.
  • If the Claim shows a Status of Payer Accepted on the Encounter Dashboard, the option Check with Payer link will be available for checking Real-Time Claim Status.
  • Encounter Dashboard > Policy Breakdown panel > Insurance line > Check with Payer
  • The Last Checked Date makes it much easier to view the last results and should also help prevent unnecessary RTCS checks.




    • Related Articles

    • Customize the Encounter by Status Panel (Claim Status)

      The Encounter by Status Panel can be customized by moving and/or adding Claim Statuses. Change the Order of the Claim Statuses On the Libraries screen, select the Claim Status button. Change the order the Statuses appear in the Encounters by Status ...
    • Automate Real-Time Claim Status with the Job Scheduler

      *Real Time Claim Status is a Premium Add-On Feature. 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 ...
    • Anesthesia Time Unit Settings

      The Anesthesia Time Unit Settings determine how time is translated into Units. Set up a default that is used for all Payers. If a Payer uses a different (non-default) logic, add a separate Time Unit Calculation Profile and link to that specific Payer ...
    • Resubmit a Claim

      Resubmit a Claim From the Encounter Dashboard, select the Change Status button. Choose Ready For Submission/Resubmission on the Payer that you are resubmitting the Claim. Add a Note if applicable. Save [F2]. Resubmit Multiple Claims in One Step Go to ...
    • Encounters by Status Panel Overview (Claim Status)

      Encounters by Status Access the Encounters by Status panel on the Claims screen or the Home Dashboard if pinned. This panel is used for short-term Claims management. The Filters can be used to search for a specific Insurance, Facility, and Billing ...