In Process-Ar Follow up

AR FOLLOW UP-CLAIM IS IN PROCESS

• Claim is under review,It is not processed yet,The normal processing time of all payor is between 30 to 45 buisness days to process the claim,Payors like Altius may take more than normal procesing time of 45 buisness days.
• We should allow normally 30 buisness days to process the claim.
• If we are getting the same status more than 30 buisness days,call the payor and check the valid reason.Some of the insurance might have pricing team for processing the claim,claim may be pending for pricing info from TPA also.
• Make sure you get received date of the claim,
• If the payor gives the valid reason,allow another 14 days to process the claim however the normal processing days should not exceed more than 45 days.If it exceeds,escalate the account to supervisor.

Example notes:precall anlaysis,claim filed on 10072016,no response received so far,

Detail description:Called xyz insurance @xxx-xxx-xxxx s/w xyz,as per rep,claim is in process,it is still in review,claim received on 10202016,Normal processing time of the claim is 30 buisness days to process the claim,rep suggested to allow another 14 buisness days to process the claim,Therefore need to allow another 14 buisness days to process the claim.