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:
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Claims are stored in the portal for 12 months. If you need them for more than 12 months, you will need to download them.
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Error responses are kept in the portal for a day, and then removed.
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If a claim is voided, the previous claim response is not displayed.
To view predeterminations and past claims:
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In the eClaims application, select the Claims tab.
The Claims list is displayed. Claims are sorted by the date of submission
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To filter the list of claims:
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Select the
Filters button.The Filters panel is displayed.
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Enter or select the values for the fields you want to include in the filter. Select Show more to display more filters.
For the Response type field:
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Acknowledgement returns payment requests with a status of Claim accepted. The request was received but adjudication was not completed.
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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.
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Problem Encountered returns payment requests and predeterminations with a status of Problem encountered
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Explanation of Benefits returns payment requests with a status of Claim accepted.
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Error(s) returns payment requests and predeterminations with statuses of Application error and Problem encountered
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Predetermination returns predeterminations with statuses of Predetermination accepted
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Predetermination Acknowledgement returns predeterminations with statuses of Predetermination pending / acknowledgement.
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Voided returns voided payment requests with statuses of Claim voided. The originally submitted request was cancelled.
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Void Request Denied returns voided payment requests with statuses of Void request declined.
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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.
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Select 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, select the x to the right of the filter value.
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To view a response in more detail, select the More
button. -
To download one or more claims or predeterminations:
Optionally filter the list.
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Select the Download
button.The Download claims pop-up is displayed. The text displayed on this pop-up varies depending on whether you applied a filter.
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Select the appropriate File format.
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Select Download claims.
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If prompted by your browser, you may choose whether to open the file (and with which application) or save it.
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To submit a claim based on a predetermination or another claim, see Submitting a claim by copying a previous claim or predetermination.
