About Reminder Claims

Here are some important things to know about Reminder claims and how they work in Tops Ortho.

What are reminder claims?

Reminder claims are claims that Tops Ortho generates for an employer policy that do not need to be submitted to the insurance company. Tops Ortho generates reminder claims so that you have claims to which you can attach insurance payments.

When are reminder claims used?

The Employer Policy below is a perfect example of when reminder claims will be used. The employer policy only requires the practice to submit the initial claim, but it pays monthly. Tops Ortho will generate the initial claim and place it in Matrix > Claims > Unsent Ready-to-File. Then it will generate reminder claims every month that the office will not be prompted to submit.

What status will reminder claims show?

Reminder claims will show as Open until the practice attaches payments to them.

Where can I see reminder claims that have generated?

You can see reminder claims in two places:

• In the patient chart. Go to View > Patient Info... and navigate to the Claims tab. Reminder claims will most often show with an Open status or a Paid status. If reminder claims were generated in error, they may show as Closed or Voided. For example, this can happen when the practice originally thinks a policy will pay monthly but they only pay quarterly. In that case, the practice will need to close or void the reminder claims to which they will not be able to attach payments.
• In the Claims Matrix. Go to Matrix > Claims. Change the top left filter from Unsent Ready-to-File Claims to All Claims in Date Range... and enter your desired date range. You can then sort the Patient column to group patients together.

Can I submit reminder claims?

No - reminder claims, by definition, are not meant to be submitted. If you have a claim you need to send that was mistakenly generated as a reminder claim, you can generate a new claim to submit. See related article, Generate a Date Range Claim, to see how.