Keywords: insurance claim queue, claim status, claim filters, print claims, send claims, dental xchange, claim history, treating provider, patient location
Summary
This article covers how to access and navigate the Insurance Claim Queue in Cloud 9. It reviews the buttons, filters, and functions available in both the patient-specific and practice-wide claim queues, including how to print, send, edit, and manage claim statuses.
Accessing the Claim Queue
To access a specific patients Insurance Claim Queue, click on the patient menu, (blue name in upper left), and then click Insurance Claim Queue. This will take you to the Insurance Claim queue that only shows claims for one patient.
To access the practice's Insurance Claim Queue click on Financial > Insurance Claim Queue. This will look at all of the claims for the practice. The functions of each queue are the same, so we can review the buttons and what they do, just know if you are in the patient's specific claim queue you will only see that one patient's claims. If you are in the larger practice claim queue, you will see all the claims.
Buttons in the Claim Queue
In the upper left there are the buttons that govern the claim queue. We will review each of them and their function. (Screenshot below shows the buttons we will review.)
Button 1: The first button that looks like two arrows traveling in a circle is the 'Refresh' button. This button refreshes the Claim queue to show any changes or new claims.
Button 2: The second button that has a printer icon is the 'Print' button. If you click it with no claims selected via the tick boxes in the Insurance Claim Queue it will show 'Print Queue Summary' as shown in the screenshot below.
If you choose to print the claim summary, it will bring up a page that looks like a report that gives a summary of all claims in the claim queue. A screenshot of what that looks like is below.
If you wish to print only one claim, you must select the tick box for a claim in the Insurance Claim Queue and then click the print button. Then click 'Print Claims.' This will bring up a preview of the claim(s) selected and a dialogue box that asks, 'Do you want to mark these claims as Printed?' This changes the status of the claim from 'New' or 'Submitted' to 'Printed.'
Button 3: The third button that says 'Send' with a paper airplane icon is the button to send a claim electronically if you have Dental Xchange integrated into Cloud 9. You must first select a claim or claims and then click the 'Send' button to send them.
Button 4: The fourth button is the blue '+' to manually add a new claim. For more information about manually creating and submitting claims, see this article: Creating and Submitting Manual Claims.
Button 5: The fifth button that looks like a clipboard with a pencil is the 'Edit Claim' button. If you select a claim and then click 'Edit Claim' it will bring up the claim form that you can then edit. If you make changes to the claim for with the 'Edit Claims' button, be sure to save the changes.
Button 6: The sixth button that says 'Status' is the Set Status button. You must select at least one claim, then you can click 'Set Status' to set the status to something different. Submitted, Printed, Deleted, etc. To add additional Claim Statuses for your practice besides the ones hard coded into Cloud 9, you would navigate to Edit > Setup > Claim Statuses.
Button 7: The last button in our upper left is the 'Claim History' button. When you select a claim and then click 'Claim History', it will show you all changes made on the claim and how they were made, (i.e., manually by an employee or automatically from a contract.)
Understanding the Insurance Claim Queue Filters
Beneath the left hand side buttons, across the next section of the screen are all the filters you can use to filter results in the Insurance Claim Queue. We will review each filter. When you want to apply a filter, select that filter and then use the refresh button discussed above to refresh the Insurance Claim Queue.
Filter 1: The first filter is the 'Claim Status' filter. You can choose to filter the results by Claim Status: New, Printed, Submitted, Deleted, etc.
Filter 2: The second filter just below 'Claim Status' is the 'Treating Provider.' You can choose to filter the claims by treating provider and you would select those providers here before clicking the 'Refresh' button.
Filter 3: The third button down is one called 'Include Substatuses.' This button will include any statuses that have a parent status in Edit > Setup > Claim Statuses. For example, you could put Printed - Awaiting payment and set Awaiting payment under the parent status of Printed. This means that it would filter by any substatuses.
Moving to the next column of filters, we will continue to review our filters.
Filter 4: The top one of the second column is called 'Claim Type.' This allows you to filter the claims in the insurance claim queue by claim type. It will default to 'All.'
Filter 5: The next one is 'Patient Location.' It will filter claims by Patient Location. It defaults to 'Showing all Locations.'
Filter 6: The last one in this column is called 'Treating Location.' It will allow claims to be filtered by Treating Location. It defaults to 'Showing all Locations.'
Filter 7: The third column has two fields, 'Patient' and 'Insurance.' These will allow you to select a specific patient or specific Insurance and filter the results based on those. These fields will be blank unless you fill them in by clicking the magnifying glass and searching for and selecting the data you need.
Filter 8: The next column is for your date range. This determines what claims will pull based on the date range. It is usually easier to filter claims when you have a set date range to use. When using the date range you must fill out both the 'Start Date' and 'End Date.'
Filter 9: The last column up top says 'Use Rank.' This means it will filter for Insurance based on the rank, Primary, Secondary etc. It defaults to 'All' but can be changed.
Filter 10: The last is a button that says 'Use Date Range.' If this is not checked to be selected it will look at ALL claims, not just those in an entered date range. It defaults to be checked and a date range entered.
The section below the filters is a list and will show all claims that you have filtered for, and some basic information like the Date, Claim Number, Status, Type, Amount, Patient, Insurance Billing, Rank, Payor ID, Patient Location, Treating Location, Provider, and Errors. If there are errors, hovering over it will tell you what the error code means.
That is the Insurance Claim Queue in a nutshell! If you have further questions, you can always contact support, or look at our other Insurance Claim articles:
Insurance Claim Information
Creating and Submitting Manual Claims
Creating Claims from Contracts
As always, if you have any further questions please do not hesitate to reach out to Cloud 9 Support by emailing us at cloud9support@planetdds.com, or chatting us online using the chat bubble on the lower right at https://cloud9support.planetdds.com/hc/en-us, or giving us a call during our business hours of 8:00 AM EST to 8:00 PM EST at the 1.800.394.6050 option 2.