Claim Statuses
Every claim carries a status that tracks it from creation to payment. The Claims tab of the Insurance hub can be filtered by any of them.
The Lifecycle
| Status | What it means | What to do |
|---|---|---|
| Draft | Created but not submitted — you can still edit or delete it | Review and submit, or file it externally |
| Submitted | Sent to the clearinghouse, awaiting payer pickup | Wait — most payers acknowledge within days |
| Filed externally | You billed this outside the platform; tracked for records only | Update it manually as the payer responds |
| Accepted | The payer accepted the claim for processing | Wait for adjudication |
| In Review | The payer is adjudicating | Wait; follow up if it lingers |
| Info Requested | The payer wants additional information | Provide it, then track the response |
| Pending | Adjudicated but not yet finalized/paid | Watch for the ERA |
| Paid | Payment posted — see Payments & ERAs | Reconcile any client responsibility |
| Deductible | Processed, but the allowed amount went to the client's deductible | Bill the client |
| Rejected | Stopped before adjudication (clearinghouse or payer front-end) | Fix and resubmit |
| Denied | Adjudicated and refused | Appeal or correct |
| Voided | Cancelled with the payer (frequency code 8) | Nothing — it's closed |
Claims that have been sitting submitted for more than 30 days are flagged in the list — if a claim goes quiet that long, check the payer portal or call, and confirm the claim wasn't lost (this is sometimes called "investigating missing payments"; the fix is the same everywhere: confirm receipt, confirm the check/ERA destination, and resubmit if the payer never got it).
Checking on a Specific Claim
Open any claim from the Claims tab. The claim detail page has four tabs:
- Status — current state and payer responses
- History — the full timeline of everything that's happened to this claim
- CMS-1500 — the claim rendered on the standard form (also what you print for external filing)
- Notes — your internal notes on the claim (great for documenting payer phone calls)
Claims carry two reference numbers, shown on the Claims tab and claim detail: the clearinghouse control number (assigned at submission) and the payer claim number (once the payer responds). Payer support will ask for these when you call.
The hub's Needs Attention count is specific: rejected, denied, and info-requested claims, plus deductible claims whose contractual balance hasn't been settled yet.