Claims Statuses in Tops Ortho
Tops Ortho has new Claims statuses as a result of our transition to DentalXChange. Here is what each status means!
- Open: A claim that has been sent and has not been marked as paid, closed or voided.
- Paid: A claim to which the practice has attached a payment.
- Closed:
- A claim that the practice closed manually, or
- A claim that closed automatically because the Employer Policy was designated "Billing Only."
- Voided: A claim that the practice voided manually.
- *Clearinghouse Accepted: eClaims status - DentalXChange has received the claim and has started the process of submitting it to the payer.
- *Clearinghouse Rejected: eClaims status -DentalXChange has rejected the claim due to missing/incorrect information.
*The Clearinghouse Accepted status and the Clearinghouse Rejection status are considered "Open" statuses, so claims with these statuses will appear in the Open Claims Only filter of the Claims Matrix.
Important Note: Claims successfully submitted from Tops to DentalXChange will display a status of “Clearinghouse Accepted.” This confirms that the claim was successfully sent to DentalXChange, but does not confirm that DentalXChange successfully submitted the claim to the payer.
Log in to your DentalXChange portal to verify that the claim was successfully sent to the payer and to review the claim status after it has been received by the payer. If DentalXChange rejects the claim, that rejection is not reported back to Tops, and the claim will continue to display “Clearinghouse Accepted” in Tops.