VanishingClaims

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Have you filed a claim to CNC but Payor Never Received it?

(The Curious Case of the Vanishing Claims…)

How many times have you contacted a payor to check the status of a claim, only to be told by the payor that they never received the claim from CNC? There is a very simple explanation for this and the good news is that it is very simple to resolve!

ChiroTrack, our electronic claims program, is specifically designed to perform custom edits of your CNC claims to identify claims that would likely be denied by the payor AND then allow you to quickly correct and resubmit those claims. The reasons we included these custom edits in the ChiroTrack system is to help assure that all of your claims can be promptly adjudicated by the payors. These edits increase the number of claims that can be promptly and correctly adjudicated by the payor - the first time they are submitted!

When the ChiroTrack edits identify a “problem claim”, the system alerts you to the problem, identifies the claim(s) with errors and even tells you why the claim cannot be transmitted to the payor. You then can easily and quickly correct and resubmit the claim. Please note, until you correct and resubmit the claim, the claim is placed on “hold” and will never be transmitted to the payor for adjudication until you have corrected the problem and resubmitted the claim! This is why the payor has not received those claims.

HOW TO PREVENT THIS PROBLEM?

Once you submit your claims to CNC via ChiroTrack, the system requires 24 hours of processing to review all of the claims in your electronic claim file, check for problems that would prevent the transmission of a claim and notify you of the status of your claims.

To make sure that ALL the claims you submit to CNC reach the payor for proper adjudication, it is imperative that you check the status of your claim file(s) 24 hours AFTER you have submitted your claim file to CNC. It takes the FULL 24 hours for all ChiroTrack edits to be performed.

For example, if you check the status of your claim file after only 8 hours, before the system has completed the 24 hour editing process, you might find that 1 claim has errored back to you. However, after the 24 hour processing cycle is complete, there may be additional claims with errors that cannot be transmitted and those claims will remain on “hold” status and will not get transmitted to the payor, until you correct the problem and resubmit the claim.

To assure ALL claims that you transmit to CNC reach the payor for adjudication, be sure to wait the full 24 hours before you check the status of your claim file.

If for any reason your file has not been processed after 24 hours, please contact your CNC ChiroTrack Rep immediately at (877) 426-2411 ext. 122 for Staci O’Dowd and ext. 125 for Cindy Current.