Call Status
In medical billing, calling the insurance company is essential to get the claim status. In most cases, we have to create a note of what we discussed on the call. Many of us face difficulty in maintaining a unique and consistent pattern for the same kind of statuses.
This tool is specially built to overcome this problem and manage data in a unique and consistent way.
Sometimes a person may forget what to ask next about a claim, and often we miss one or two important things that later become a problem for us. But if we use this tool during the call, our problem ends. This tool is also helpful for those who want to learn or who are new in the medical billing field.
It reduces the time needed to create notes manually and makes our work more productive.
How to use:
In this tool, it is not necessary to fill all the boxes. There is no restriction on any box being mandatory. Simply fill in the boxes you need, and you’ll get the best formatted results.
All dates must be entered in the MM/DD/YYYY format.
If you need a specific box or certain options in the menu boxes, contact us — we’ll definitely respond to you.
We do not save any of the information you enter on this website or in any of the tools.
There are about 30 input boxes, and I’ll discuss each of these input boxes one by one using their names.
Insurance Name: In this box, enter the name of the insurance company you are calling, e.g., Aetna, Cigna, etc.
Insurance Number: This box is designed to enter the insurance contact number. The preferred format is 123-456-7890.
Date of Call: This box is for entering the date on which the call was made. The format must be MM/DD/YYYY (standard).
Representative Name: This box is designed to enter the name of the insurance representative, e.g., John K, etc.
Received Date: This box is for entering the received date of the claim. The format must be MM/DD/YYYY (standard).
Processed Date: This box is for entering the date on which the claim was processed. The format must be MM/DD/YYYY (standard).
Claim Status: This is a dropdown menu where you need to select the claim status, e.g., Paid, Denied, etc. Based on your selection, multiple boxes will appear. The displayed boxes will differ for each selected status.
Claim Number: This box is for entering the claim number. Each insurance company has its own unique claim number format.
Allowed Amount: This box is for entering the allowed amount of the claim.
Paid/Approved to Pay Amount: Enter the paid/approved-to=-pay amount in this box.
Copay: Enter the copayment amount for the claim in this box.
Deductible: Enter the deductible amount for the claim in this box.
Coinsurance: Enter the coinsurance amount in this box.
Payment Method: This is a dropdown menu with different payment methods. By default, it is set to Check.
Payment Number: This box is for entering the payment number, such as the Check Number, EFT Number, etc.
Payment Date: Enter the date on which the insurance made the payment (e.g., check date or EFT date). The format must be MM/DD/YYYY (standard).
EOB Requested: This box indicates whether the EOB (Explanation of Benefits) was requested or not. It will appear in the results only if the dropdown is selected as YES.
Reason for Not on File: This is a dropdown menu containing various reasons why the claim is not on file.
Denial/Rejection Reason: This box is for entering the denial or rejection reason of the claim. The input should be short and to the point, but it can also be detailed if necessary, for example, missing authorization, lack of information, or missing/invalid modifier, etc.
FAX#, Mailing Address, or Other Info: This box should contain a complete sentence with any additional information about the claim or insurance obtained from the representative. For example: “The Fax# is 123-456-7890” or “The correct payer ID for the insurance is ABCDE”, etc.
Action Taken: This is a dropdown menu containing various corrective actions performed during or after the call, such as Sent back for reprocessing, Sent appeal, etc.
Changes You Made: This box is used to mention any changes made to the claim. For example: Changed 99214 to 99213 or Added modifier 50, etc.
TFL for Corrected Claim: If a corrected claim needs to be submitted, this box is used to enter the TFL (Timely Filing Limit) for the corrected claim. Enter the limit in days or months, e.g., 4 months.
TFL for Appeal: If an appeal needs to be submitted on the claim, this box is used to enter the TFL (Timely Filing Limit) for the appeal. Enter the limit in days or months, e.g., 120 days.
Submission Resource: This is a dropdown menu containing different submission methods or resources, such as Fax, Mail, etc., where supporting data, documents, or appeals are submitted.
FAX# or Mailing Address: If data is submitted through fax or mail, enter the corresponding fax number or mailing address here.
Submission Number: If data is submitted through Availity or any other portal, there will be a submission number, enter it here. If not applicable, leave the box empty.
Submission Date: This box is for entering the date on which documents, appeals, or other materials were sent. The format must be MM/DD/YYYY (standard).
Turnaround Time (TAT): When the representative sends the claim back for reprocessing, a turnaround time should be obtained. If provided, enter it here.
Call Ref#: It is also an important part of documentation. Always obtain and enter the call reference number so it can be used for future reference or follow-ups.
Input Boxes;
Result Boxes;
There are about three result boxes, and each of these provides the result in a different format.
Choose the result format you prefer from the three different result boxes.
All the result boxes have two icons: Edit and Copy.
If you think a small modification is needed in the result, simply click on the Edit icon and adjust the result according to your preference.
When you click on the Copy icon, whatever data (edited or original) is present in the result box will be copied to your clipboard.
If you edit the data but then realize you shouldn’t have made changes, simply click the Submit button — the result will be updated again to its original form.
Contact us
If you notice any incorrect information on this website, or if you have valuable knowledge or updates related to any page that could benefit others, we encourage you to share it with us. After verification, we will add it to the site for the benefit of the billing community.
You may also suggest specific information you would like us to include, and we will follow up on your request as soon as possible.
We look forward to your contributions. Thank you.