Tracking Insurance Claim Status
When you submit an electronic claim, the application creates and sends an 837 EDI file to the clearinghouse (Office Ally). After that, you or the system cannot control your claim. Fortunately, the application allows you to track your claim’s status.
 Login to your zHealth account. At the top right corner of the dashboard, click on your name. From the drop-down menu, click on - Billing Center.  The Billing Center shows all your invoices that you can submit to the clearinghouse as well as claims that have already been submitted. |
| You can track the status of each claim by checking the Active Claim Status tab. Every message sent by the clearinghouse or payor to the zHealth application has the ability to change the status under the Active Claim Status bar. |
| IS - Invoice is Ready for Submission As soon as the charges are entered in the patient’s invoice, the claim status will be shown as IS - Invoice is Ready for Submission. Note: Users have the ability to change the claim status manually from IS -> RS -> 2S or vice versa using the "Edit Claim Status" button. |
| RS - Ready for Submission When you have reviewed your claim and deemed that it’s ready for submission, you’ll need to manually change its status from IS to RS - Ready for Submission. Note: This is effective when you need to communicate with an external billing company or in-house billing staff. Users have the ability to change the claim status manually from IS -> RS -> 2S or vice versa using the "Edit Claim Status" button. |
| SE - Error while Submission The claim status changes to ‘SE’ when an error occurs during the claim submission process. |
| SO - Submitted to Clearinghouse When a claim is submitted, the system sends it to the clearinghouse and the status changes to SO - Submitted to the Clearinghouse. |
| 9S - Received Success Acknowledgment from Clearinghouse (999) When a clearinghouse receives the claim (837 file) successfully, they send back a 999 Acknowledgement receipt file to the zHealth system. Upon receipt of the acknowledgment message from the clearinghouse, the system will automatically update the claim status as 9S. Note that this status does not mean that the claim will be accepted and processed by the insurance company. |
| 9E - Received Error Acknowledgment from Clearinghouse (999) When a clearinghouse receives the claim (837 file), they review it and if there is a data problem, they send an error message back to your account. In that case, the claim status will be shown as 9E. The errors in the claim could be “missing non-billable codes”; “missing secondary insurance information in secondary claims”; “claim was submitted to the wrong payer, and so on. |
| 2S - Received Success Acknowledgment from Clearinghouse (277CA) The clearinghouse scrubs the claim and checks for errors. If the claim has no errors and can be securely transmitted to the insurance payor, it sends a 277CA success acknowledgment message to the system. The system then automatically updates the claim status as 2S. Note: A successful 277CA acknowledgement is not a guarantee of payment. The status information being provided is based on the claim’s characteristics at a given point in time. Users have the ability to change the claim status manually from IS -> RS -> 2S or vice versa using the "Edit Claim Status" button. |
| 2E - Received Error Acknowledgment from Clearinghouse (277CA) The clearinghouse scrubs the claim and checks for errors. If the claim has errors, the clearinghouse sends a 277CA error acknowledgment message to the system. The system then automatically updates the claim status as 2E. |
| 8S - Received Success EFT from Payor The clearinghouse sends the claim to the insurance payor. The insurance payor adjudicates the claim and processes it. The payor then sends an electronic remittance advice (ERA) to the clearinghouse, which is then sent to your account through the zHealth system. When the ERA shows no errors for the given claim, the status will be shown as ‘8S’. ERA contains claim payment and remittance details, such as the status of claims payments, financial errors, and payer responses to claims. |
| 8E - Received Error EFT from Payor The clearinghouse sends the claim to the insurance payor. The insurance payor adjudicates the claim and processes it. The payor then sends electronic remittance advice (ERA) to the clearinghouse, which is then sent to your account through the zHealth system. When the ERA shows financial errors for the given claim, the status will be shown as ‘8E’. |
| CE - Claim Errors When the claim lacks information or has billing errors that are needed for adjudication, the status is shown as ‘CE’. Additional information is supplied using ERA remarks codes whenever appropriate. |
| RE - Rebill If there is a claim that was already billed but for some reason needs to be rebilled, you can manually change the status to ‘RE’. |
| OH - On Hold zHealthEHR Practice Management Software automatically places claims on hold when you select Edit Claim. You can also place a claim ‘On Hold’ manually. |
| S and P Superscripts The little “P” and little “S” next to the claim status stands for the status of “Primary” or “Secondary” claims. |
zHealth software provides you with the ability to delete active claim unless its status is 8S. This means you can delete active claims that have the following statuses - IS, RS, CE, 2S, 2E, 9S, and 9E. You will be able to delete active claims that can be Primary, Secondary or Tertiary claims. |
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