Claim status calling process

Calling Insurance for claim status

How to call for claim status

A/R callers either take status from IVR or from Insurnace representative , for both IVR or respresentative, A/r caller need to provide below things in order to verify him.

1. Provider name
2. provider ID
3. provider tax id
4. provider NPI

Then you will be able to take claim status and for that you need

1. Patient id #,
2. Patient Name
3. Date of Birth
4. Date of Service
5. Billed amnount on claim

Then representative will let you know

Claim would either not on file, in process, approved to pay , Paid or Denied

If it is paid, You will come to know

1. Allowed amount
2. Patient Responsibility
3. Paid Amount
4. Check Number
5. Check Date

and if there is any Denial, then it will let you know denial reason.

If its not on file, you need to check wheather the claim is submitted or not, and if yes, do check mailing address.

If its in process, then you can ask process days and wait for the process to complete

If its approve for payment, you can payment details.