Manage Claim¶
What this is for¶
Manage Claim is where you find claims and open one to work on it. You can search by patient, claim number, dates, amounts, payer, provider, tags and more, group the results, and act on every claim that matches — assign a task, queue a claim status check, bulk update or export to CSV.
On the screen itself the heading reads Search Claim; the menu calls it Manage Claim. They are the same screen.
Before you start¶
- Open it from the menu: Claim → Manage Claim.
- It searches as soon as it opens and shows the newest claims first. There is no date limit until you set one.
- Buttons you do not have the right for are simply not shown — for example Add New Claim, Bulk Update, Quick Edit and Delete. Ask your administrator if you need one.
Steps: find a claim and open it¶
- In the search row, fill in what you know — for example Last Name, or a Claim Number (CSV).
- Click Search, or press Enter.
- Find the claim in the results. The newest are at the top; use Order By to sort differently.
- Click its Claim #. The Claim Summary opens in a new tab. To change the claim, click Edit claim there — see Enter or edit a claim.
Several claims at once
Fields marked (CSV) take several values separated by commas — for example
10021, 10022, 10030. The clipboard icon beside Claim Number (CSV) pastes what you
copied.
The search row¶
| Field | What to enter |
|---|---|
| From Created / To Created | The date the claim was created in eClaim Pilot. The ⋮ beside it picks a range: Today, This Week, This Month, Last 3 Month, This Year and more. |
| Last Name, First Name | The patient's name, or its start. |
| Patient # (CSV) | One or more patient numbers. |
| Claim Number (CSV) | One or more claim numbers. |
| Billing Type | All, HCFA (professional) or UB (institutional). |
| Hold Status | Both, On Hold or Active. |
Reset puts every filter back to its default and searches again.
Two lists above the results also filter and sort, and they apply as soon as you choose:
- Claim Condition — ready-made filters such as Unbilled Claims or Claim with credit balance.
- Order By — Created, Claim #, patient name or date of service (DOS).
Advanced Search¶
Click Advance Search for every other filter. It opens a panel with sections — open one at a time:
| Section | Filters |
|---|---|
| Date Condition | DOS, Entry Date, Created Date, Last Ins Posting, Last Patient Posting |
| Amount Condition | Billed, Ins Payment, Pat Payment, Balance, Pat Balance, Ins Balance |
| Claim Information | Created By User, Encounter Number, Claim Number, Claim Batch Name, Bill To, Place of Service |
| Import Details | Import File Name, Import Batch Name, Upload Date |
| Demographics | Patient #, Medical Record Number, External Id, Patient Status |
| Provider / Facility | Billing, Rendering and Referring Providers, Facility |
| Payer | Primary and Secondary Payer, Primary and Secondary Payer Type |
| Other Provider | Referral Sources, Ordering Facility, Resident, Supervising, Assistant and Ordering Provider |
| ICD and Procedures | Procedure Codes, ICD Codes |
| Tasks | Task Assigned (Any, Has Tasks, No Tasks), and Assigned To User |
| Tags | Claim Tags, Patient Tags, Payer Tags |
Beside many fields:
- [Any] — only claims where the field has a value.
- [Empty] — only claims where the field is blank, e.g. no referring provider.
- [Exclude] — everything except what you entered. It stays highlighted while on.
- The list icon opens a look-up to pick values instead of typing them.
Click Search in the panel to search and close it, or Close to close it without searching.
Reading the results¶
The results show as cards at first. The two icons at the right of the results bar switch between cards and a table. Total Claims shows how many claims matched.
On each claim:
| Icon or link | What it does |
|---|---|
| Claim # | Opens the Claim Summary in its own tab. |
| Patient, Facility, Payer, providers | Open that record's summary. |
| Quick View — ICD & CPT | A read-only look at the balances, diagnoses and line items. |
| Quick Edit | Edits the claim's codes, providers and other details in a side panel, without leaving the list. Previous and Next move to the next claim. |
| View Claim Summary | Same as clicking the claim number. |
| Copy and create New Claim | Starts a new claim copied from this one. |
| More actions | Claim Form View, Claim Statement View, EDI Preview, Claim Transactions, Claim Line Item Summary, Event Log, Transmission History and Notes. |
| Delete | Deletes the claim, after two confirmations and your authorization password. |
A red On hold badge marks a claim that will not be sent until the hold is released.
When you open a claim and come back, your filters and page are still there.
Group By¶
Click Group By and choose Facility, Rendering Provider, Billing Provider, Primary Payer Type or Patient Balance Range. A panel on the left lists each group with its number of claims; click one to see only those. Clear Group goes back to the full list.
Working on many claims at once¶
These buttons act on every claim that matches your current search — there are no check boxes to pick claims. Narrow the search first so it matches exactly the claims you mean.
| Button | What it does | Limit |
|---|---|---|
| Assign Task | Creates a task on each matching claim. You can skip claims that already have an open task. | 50 claims |
| Add to Claim Status Check Queue | Queues each matching claim for a claim status check with the payer. | 50 claims |
| Bulk Update | Opens Bulk Update for the matching claims. | 300 claims |
| CSV Export | Exports the matching claims to a CSV file. | — |
Over the limit, you are told how many claims matched; narrow the search and try again.
CSV Export asks which column set to use. Export Now downloads the file straight away; Run in Background is for large exports — reopen CSV Export later and click Download on the last generated file.
Common problems¶
| You see | Why | What to do |
|---|---|---|
| A claim you know exists does not show | A filter is still set — often in Advanced Search, or Hold Status, or a Claim Condition. | Click Reset and search again. |
| No Add New Claim, Bulk Update, Quick Edit or Delete | Your role does not have that right. | Ask your administrator. |
| "Only up to 50 Claims can be bulk assigned at once" | More than 50 claims match. | Narrow the search, then try again. |
| "Only 300 claims is the limit for bulk action" | More than 300 claims match. | Narrow the search, then try again. |
| A claim cannot be sent | It is on hold — it shows the red On hold badge. | See Put a claim on hold to release it. |
| "Unsaved Changes" in Quick Edit | You moved to another claim with changes not saved. | Click Save or Reload first. |