Review imported insurance claims

Use Insurance > Imported claims to review claims imported from Claim.MD or Stedi. These steps apply to workspaces with Insurance enabled.

Imported claims stay in this list until someone moves them into Claims. Automatic review on Setup can move a claim when patient, policy, provider, encounter, and service matches are confirmed.

Import history

1. Open Setup.
2. On the connection, select Import Claim.MD history or Import Stedi history.
3. Return to Imported claims. Filter by status or service date, or search.

Empty imported-claims lists point you to Manage connections on Setup.

Match and move a claim

1. Open an imported claim.
2. Under Find related records, select the provider when more than one is listed.
3. Select Find matches.
4. Review the suggested patient, encounter, policy, and remittance matches.
5. Select Move to claims. The sheet title is Move to claims.
6. Confirm the patient, encounter, policy, diagnoses, and service lines. Select Move to claims.

View claim opens the native claim after it is in Claims. Claims with remittances enter payment review. Claims with confirmed rejections can be corrected from the claim page with Correct or void.