Control Section

The Control section of the application provides functionality to track claims that have been submitted, control and resubmit claims at a batch level, track patient statements, and control patient accounts receivable (AR). In addition, it provides the functionality for printing claims, statements, superbills and final demand notices (FDN) at a batch level.

The following help pages are supported by the current version of CollaborateMD. Please follow the curriculum outline to receive the proper training associated with this section.

Button Overview

Below you will find a description of the buttons located within the the Claim Tracking tab:
Search: This button will search for claims using the filter selections entered.
Save: This button allows you to save your changes.
Print: This button allows you to print your claims list.
Close: This button will close the section without making any changes.
Select Columns: This button will allow you to set your display columns.

Claim Tracking allows users to track accepted, rejected and resubmitted claims in an easy to view format.

Tracking Claims

Follow the instructions below to track your claims:

  1. Go to the Control section.
  2. Click the Claim Tracking tab.
  3. Begin entering your search criteria: 
    • Claim Criteria: 
      • Claim Type: Select the claim type from the drop down
        • All: This includes all types of claims. 
        • Electronic: These are the claims that were forwarded electronically to the payer. 
        • Paper: These claims were sent electronically to the clearinghouse and then printed on a claim form and mailed to the payer. 
        • User Print: These are the claims that you print and mail to the payer yourself. 
      • Tracking Status: Select your tracking status from the drop down
        • All: This option includes all tracking statuses.
        • Accepted: This option will only display claims accepted at the clearinghouse. 
        • Rejected - All: This includes all claims that were rejected at the clearinghouse, even if they have subsequently been resubmitted and accepted. 
        • Rejected - Not Fixed: This will display only the claims that were rejected by the clearinghouse and have not been fixed and resubmitted. This is a good option to choose if you want to work on correcting claims that need to be resubmitted. 
        • Rejected - Fixed: This option displays only those claims that were initially rejected at the clearinghouse, but which have since been corrected and resubmitted. 
        • Warnings: This option includes claims that have a warning message attached to them. 
        • No Errors: This option will include claims that have no errors.
      • Claim Status: Select the current claim status from the drop down menu.
      • Processing Mode: Select the processing mode of the claim from the drop down.
      • Edit Level: Select your edit level from the list in the drop down menu.
        • Front-End-Edits: These are edits received prior to the claim being adjudicated.
        • Back-End-Edits: These are edits received after a claim has been adjudicated.
      • Include: Select whether you would like to show Professional claims, Institutional claims, or both.
      • Real Time Claim Status Reports: Select whether you want to limit your results to ONLY real-time claim status reports.
    • Claim Tracking Date Range: Enter the dates for the specific claims you would like to search for. You can choose dates from the drop down menu or enter them manually. 
      • Claims Submitted: This option will search for claims that were submitted within the date range provided.
      • Tracking Status: This option will search for claims based on the tracking status date that falls within the Claims submitted date (if selected).
      • Date of Service: This option will search for claims with dates of service that match the dates selected.
    • Payer Types: Select the payer type specified for the payer. By default (All) payer types will be selected. Uncheck the (All) box and select the payer type(s) you wish to search for.
    • Search Criteria: You can narrow down your claims list by entering search criteria. You can manually enter the information or select the magnifying glass to search for the information.
    • View Options: 
      • Group by: This selection will determine how claims are organized. You can use this in conjunction with the Search By field to quickly find the claim you are looking for.
      • Then by: You can also select a second Group By option called Then By, with the choices being the same as those above. Example: you can choose to view claims organized by payer, and within that organized according to their submission date. First, claims for Payer A would be displayed in date order, then claims for Payer B in date order, and so on.
      • Include Claim History: If you check this box, any information received electronically will be included with the claim information. Be sure to leave this checked if you wish to view any messages that may have come back from the payer electronically when you view the claim. 
      • Expand All: If you check this box, all of the informational messages are going to be automatically opened on the report and you will not have to expand the reports manually to read items such as the Claim History. However, if you only wish to view certain claims, you can uncheck this box. Only a list of claims will be displayed, allowing you to scan the claim list more quickly and choose only the claims you wish to view. 
      • Ignore Duplicates: If you check this box, any duplicate claims will be ignored in the total claims counter found at the bottom of the screen. Duplicate claims occur when you resubmit a claim (e.g., a claim that was rejected at the clearinghouse). 
  4. Once you are done, click Search.

Right Click Capabilities

These right click capabilities will give you easy access to the information you want when you want it. 

Follow the instructions below to view the right-click capabilities:
  1. Go to the Control section.
  2. Click the Claim Tracking tab.
  3. Enter your search criteria then select Search
  4. Once your search results are displayed, right-click on a row. A window will open with the following options:
      • Edit: Allows you to open and edit any associated sections within the application. 
      • Show Details: Shows claim details. Right clicking on each row provides different claim details that include Activity Details, SF Report, Claim Status, and Status Details.
      • Error Fixed: Allows you to mark warning and rejected claims as error fixed. This feature should be used in conjunction with the Tracking Status filter as it will help you drill down on the claims that haven't been corrected.  

    Marking Claims as Error Fixed

    In the event, a claim is marked as rejected and you've corrected and resubmitted the claim within the CollaborateMD application, you can mark the claim as Error Fixed. This will place a green check mark beside the rejection message showing that it has been fixed. Marking claims as error fixed will allow you to keep track of the claims that you need to follow up on.

    Follow the instructions below to mark a claim as Error Fixed. 
    1. Go to the Control section.
    2. Click the Claim Tracking tab.
    3. Enter your search criteria and then click on the Search button when you're done. Tip: Change your Tracking Status to Rejected All or Rejected - Not Fixed to constrain your results by claims that have been rejected.
    4. Right click on the rejection you want to fix, or highlight multiple claims by clicking and dragging your mouse or using other keyboard shortcuts, and then right click on the highlighted lines you want to fix. 
    5. When the pop up box opens, at this point, you can hover your mouse over Edit and choose to open the corresponding sections 
    6. OR select Error Fixed to mark the error as fixed. IMPORTANT: Please be sure that you've corrected any errors that the claim originally received prior to marking it as fixed. Marking the claim as error fixed doesn't automatically correct the error. 
    7. A dialog window will appear asking if you wish to resubmit the claims that you've marked as fixed select.
      • Resubmit Claims: Selecting this option will mark the claim as corrected and WILL resubmit claims.
      • Don't Resubmit: Selecting this option will mark the claim as corrected but will NOT resubmit the claim. 
      • Cancel: Selecting this option will cancel your changes and return you to your tracking results.
    8. When you're done marking the claims as Error Fixed, click on the Save button.
    Note: When searching for future claims via Claim Tracking please utilize the Tracking Status filter to constrain the results based on the tracking status of the claim if they've been marked as corrected or not.