Carepatron allows you to submit and track electronic claims for US-based professional services using our integrated clearinghouse partner, Claim.MD. This guide explains how to monitor claim statuses, handle rejections, and manage payments.
✅ Submitting Electronic Claims
You can submit electronic claims if the payer on the claim has been imported from Claim.MD.
For guidance on creating and submitting claims, refer to: How to Create a Claim
📊 Monitoring Claim Status
After submission, Carepatron continuously monitors updates from Claim.MD and the payer. You will also receive in-app notifications for any status changes.
To track claim progress:
Go to your Claim List
Click to open a claim
Check the claim status in the header
If available, a reason will display next to the status
Click the History icon in the header to view:
Updates
Payer messages
Claim.MD communication logs
📌 Claim Status Definitions
Status | Meaning |
Validated | Ready to submit. Not yet sent to clearinghouse or payer. |
Submitted | Sent to the clearinghouse; under review or routing to the payer. |
Rejected | Not accepted by the clearinghouse or payer. Requires correction. |
Denied | Rejected by the payer. Must be appealed outside of Carepatron. |
Accepted | Accepted by the payer for processing. |
Partially Paid | Payment linked, but not covering the full claim amount. |
Paid | Full payment received and linked to the claim. |
🔁 Resubmitting Rejected Claims
To fix and resubmit a rejected claim:
Open the rejected claim
Review the error messages at the top
Revert the claim to Draft
Correct all necessary details
Ensure the resubmission code is present (this is auto-filled if applicable)
Submit the claim again
Note: Error language may come from Claim.MD or the payer and may differ from Carepatron’s terms.
📄 Viewing ERAs and Adjustments
If the payer enrollment for Electronic Remittance Advice (ERA) is complete:
Payments will be automatically applied to matching claims.
Adjustments will be shown directly in the claim history.
To view:
Open the claim
Review the history for payment received messages
Click View remittance for the full ERA and adjustment breakdown
Click View payment to see payment details and allocations
❓ Handling Unallocated Payments
Sometimes, Carepatron can’t automatically link payments to claims.
To manually reconcile:
Open the Client Billing page
Go to the Payments tab
Filter type to Insurance and status to Unallocated
Select the payment, click Edit payment details
Allocate the amount to the correct billing items
Click Save
🧾 Manually Recording Payments
You can also manually record payments for Approved or Partially Paid claims.
To record a manual payment:
Open the claim
Click Add payment in the header
Enter the payment amount
Add identifying details (date, payer, reference #)
Allocate the payment to the correct billing items
Click Save
Our team will be able to answer any other questions you may have. Just reply via messenger through the Help channel in your workspace.