If you've filed a claim on Healthy Bytes and waited anxiously for it to be approved, you're probably familiar with the Claim Status page. For those of you who are just joining us, here's a screenshot so you're familiar:
On this searchable page, you'll see a list of all the claims you've entered into our system. Here's a breakdown of what the labels in the status column are telling you:
Processing: we've received the claim and we've filed it with the insurance company. Now, just like you, we're waiting for it to get approved. The time for this status to change depends on how quickly the insurance company processes the claim.
Enrollment: indicates that the insurance company required additional paperwork in order to start filing your claims electronically. Not to worry - these claims will be processed as soon as you’re approved for electronic claim submission.
Info Needed: this status indicates that the claim is missing required information (address, DOB, incorrect member ID, etc.). Click on the claim status and a pop-up window will appear showing what information is needed; simply click the “Ready to submit?” box and a text field will appear where you can enter the required information. After entering the required information, click submit and we will automatically receive the new information and start re-processing the claim.
Refiled: the claim is being re-processed by the insurance company.
Denied—Info Needed: the claim was denied by the insurance company for not having all the required information (e.g. name of referring provider) or because they are requesting medical records to review in making a determination of medical necessity.
Denied: the claim was correctly denied by the insurance company and no further action can be taken.
Deductible: the claim has been approved and was applied to the deductible. The patient is responsible for paying the allowed amount shown in their EOB.
Approved: the claim has been approved was paid by the insurance company. Your reimbursement is on its way!
We hope this answers some of your more burning questions when it comes to claim statuses!