Viewing predeterminations and past claims

You can view the history of the paid claims.

The following rules define whether a claim is displayed in the portal, and for how long:

  • Claims are stored in the portal for 12 months. If you need them for more than 12 months, you will need to download them.

  • Error responses are kept in the portal for a day, and then removed.

  • If a claim is voided, the previous claim response is not displayed.

To view predeterminations and past claims:

  1. In the eClaims application, click the Claims tab.

    The Claims list is displayed. Claims are sorted by the date of submission

    Claims tab

  2. To filter the list of claims:

    • Click the filters icon. Filters button.

      The Filters panel is displayed.

      Filters pop-up

    • Enter or select the values for the fields you want to include in the filter. Click Show more to display more filters.

      For the Response type field:

      • Acknowledgement returns payment requests with a status of Claim accepted. The request was received but adjudication was not completed.

      • Timeout returns payment requests with a status of Connection errors.The request did not reach the insurance company or was not processed within the expected timeframe.

      • Problem Encountered returns payment requests and predeterminations with a status of Problem encountered

      • Explanation of Benefits returns payment requests with a status of Claim accepted.

      • Error(s) returns payment requests and predeterminations with statuses of Application error and Problem encountered

      • Predetermination returns predeterminations with statuses of Predetermination accepted

      • Predetermination Acknowledgement returns predeterminations with statuses of Predetermination pending / acknowledgement.

      • Voided returns voided payment requests with statuses of Claim voided. The originally submitted request was cancelled.

      • Void Request Denied returns voided payment requests with statuses of Void request declined.

      • Void Timeout returns payment requests with statuses of Connection errors. The void request did not reach the insurance company or was not processed within the expected timeframe.

    • Click Apply filters.

      The list is filtered. The filter values are included at the top of the list. To clear an aspect of a filter without launching it, click the x to the right of the filter value.

      Submitted tab with some filters applied

  3. To view a response in more detail, click the More more icon. button.

  4. To download one or more claims or predeterminations:

    Optionally filter the list.

    • Click the Download download icon. button.

      The Download claims pop-up is displayed. The text displayed on this pop-up varies depending on whether you applied a filter.

      Download claims pop-up

    • Select the appropriate File format.

    • Click Download claims.

    • If prompted by your browser, you may choose whether to open the file (and with which application) or save it.

  5. To submit a claim based on a predetermination or another claim, see Submitting a claim by copying a previous claim or predetermination.

info icon Related info

Voiding or cancelling a claim

Insurer payment cheat sheet