Claim Status Reference Table

By March 12, 2019EDI / Claims

There are a few different claim statuses that will show on the ledger under the status column.

The first letter represents the status of the treatment. By default, there are three different treatment statuses in Power Practice.

The second letter is the EDI Status which is assigned by the insurance company and users are unable to change this status without reversing the treatment and resubmitting the claim.  Below are the following definitions of the different EDI statuses that the insurance companies use.

Power Practice Status Codes (First Letter)

Code Label
C Completed
I Incomplete
P Planned

Insurance Status Code (Second Letter)

Code Label Description
A Acknowledged The Insurance Company has acknowledged receipt of the claim.
R Rejected The claim was rejected. See the claim printout for the rejection details.
V Void The claim has been reversed.
B Batched The Insurance Company is set to the Batched submission method in the Insurance Company settings.
– or –
The EDI manager program isn’t running on the server (uncommon).
X Error There was an error while processing the claim. See the claim printout for the error details.
M Manual Insurance company wants the claim submitted manually.
P Pending Claim is pending review from the Ins Co. See the claim printout for more information.
W Waiting Claim is waiting and has not been sent to the insurance company yet.
– or –
EDI Manager application isn’t running.
E Explanation of Benefits Will show what the Insurance Company intends to pay.