How to View Claim Audits

How to View Claim Audits

To assist in better claim management, the Claim Audit option on a claim record provides the tracking of key changes made to the claim. Anytime a change is made to a claim record, the log will record the following:

  • Patient Name: The name of the patient for which the claim is being submitted
  • Date of Service: The date when the service was rendered to the patient.
  • Current Primary: The name of the primary insurance of the patient 
  • Current Secondary: The name of the secondary insurance of the patient
  • Claim ID: Unique identification number assigned to a claim by our software
  • Date: The date when the action was performed
  • Status: The status of the claim submission or action taken on a claim
  • Message: What was the action taken
  • Information Received: Any information received from clearinghouse or payer
  • TraceID: All claims submitted to Change Healthcare will have Traceid. This is a unique identifier that helps to get more details about a claim.

To view the Claim Audits:
  1. You can go to the Billing Center > Click on "menu" icon or "four horizontal lines" icon provided in front of each claim.
  2. You can go to a Patient Chart > Patient Billing > Click on "menu" icon or "four horizontal line" provided in front of each claim.

If any changes were made to the claim record, a list of changes will be shown. For example, if a claim is submitted, the claim ID, submission status, date, and any other related information would be shown.

1. Claim Audits in the Billing Center


Info
a. Access your zHealth dashboard. Hover your cursor over your name on the top right side of the screen. Click on "Billing Center."



Info
b. In the Billing Center page, click on the "menu" icon or "four horizontal line" icon as show on the image here. A pop-up window will open.



Info
c. The Claim Audit Window will provide the following information:

  1. Patient Name
  2. Date of Service
  3. Primary Insurance
  4. Secondary Insurance
  5. Claim ID
  6. Date
  7. Status
  8. Message
  9. Information Received
  10. TraceID*

Notes
Note 1: *TraceID only shows up if the claim is submitted through the Change Healthcare clearinghouse.

Note 2: Deleting a claim will now show the audit trail of when the claim was deleted and the deleted claim number (Check the second screenshot).




2. Claim Audits in the Patient Billing


Info
a. Access your zHealth dashboard. Search the patient name using the top navigation search box. Click on the patient name from the populated results to open the Patient Chart.



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b. In the Patient Chart Center, click on the "Patient Billing" option.


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c. Click on the "four horizontal lines" icon provided in front of each claim record. The Claim Audit Window will open. You can view the following information:

  1. Patient Name
  2. Date of Service
  3. Primary Insurance
  4. Secondary Insurance
  5. Claim ID
  6. Date
  7. Status
  8. Message
  9. Information Received
  10. Traceid*

Notes
Note: *TraceID only shows up if the claim is submitted through the Change Healthcare clearinghouse.



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