Pending Claims

Pending Claims Overview

The new and improved Pending Claims page provides a centralized location for managing all Medicare and Managed Care claims that have outstanding balances. It streamlines operations by consolidating multiple functionalities and optimizes ease of use by gathering all claims with a remaining balance in to a ‘ready to work’ location.

Benefits of Pending Claims

  • The Pending Claims window establishes a seamless workflow by enabling users to document check details, post payments, and make adjustments in one place.
  • It is essentially a workable Account Receivable window with an enhanced user experience.
  • In contrast to the previous Pending Claims window, the new page eliminates restrictions that occur when handling multiple Payer Types.

Accessing Pending Claims

The Pending Claims page is only accessible to users with the Access Billing Center permission.



To access the Pending Claims page, navigate to the Billing tab and select Pending Claims from the drop-down menu.


Functionality of Pending Claims

Refined New Filters

  • The ability to filter by date range, specific payers, and patients by status enables users to easily locate specific pending claims.
  • The Pending Claims page displays claims with the following criteria:
  • – Claims that have a remaining balance, either Negative or Positive
    – Claims that do not have the status Created or Reopened

  • Additionally, a filter to select either RAP, Final, or Managed Care is also available for users.



Sortable Columns

  • The data generated from the filters is displayed in table columns, which contain sorting capabilities.
  • The user can update receivables of claims with remaining balances.


Aging Metrics

  • An exciting new Aging Metrics feature enables filtering and gives users an at-a-glance view of aging claim buckets.
  • The metrics are calculated from the claim’s bill date to the current date.
  • Users can click on a specific bucket to filter down the list and view only claims within that corresponding age range.
  • The calculations are split into the following categories, which can be filtered by simply clicking on the color code:
  • o 0-7 days old
    o 8-30 days old
    o 31-60 days old
    o 61-90 days old
    o Over 90 days old


Edit Claim Information

  • Pending Claims creates ease of use by gathering all claims with a remaining balance to a centralized claim management window.
  • The Ready to Work claims with an outstanding balance can be viewed and addressed in one screen for all payer types.
  • The Edit button integrates both the claim posting and adjusting capabilities to easily update claim balances from a single screen.