How to Manage Claims

Claim Management

Unsent

The Unsent tab holds all of the claims that are waiting to be sent to insurance. 

Because Vyne Trellis is web-based, the Unsent tab is shared amongst all users associated with a single Vyne Trellis account. This means if a user on Computer A sends a claim from the PMS to Vyne Trellis, a user on Computer B may also see a claim in Vyne Trellis, in the Unsent tab, before it is processed and sent to insurance!

The Unsent tab provides the following columns of information by default:

Column
Description

Actions

Send, Delete, Hold, Release, Ignore Attachment Requirements

Details

Attachment Options

Patient Name

 

Subscriber Name

 

Carrier

 

Status

Failed Validation, Ready, Other Coverage indicators, On Hold

Status Description

Validation Errors, including Attachment Requirements

How to Edit Available Columns

  1. Select the column selector icon in the upper right corner. 
  2. Toggle the columns on/off to add or remove the column from the view. 
  3. Select Save.

Claim Validation

Claims displayed in the Unsent tab must be approved before they are sent to insurance. The Unsent tab provides validation errors, represented in red. For example:

Note: Claims with validation errors or On Hold will remain Unsent until the claim(s) are corrected, released, or deleted: 

  • Attachment Requirements, example: “Attachment Required: XRAY
  • Claim Validation Errors, example: “Failed Validation: Subscriber ID
  • On Hold example: User may choose to hold a claim from being submitted to insurance until the user has selected to Release the claim
  • Any claim that does not have a validation error will also display “Ready”

View or Edit a Claim

  1. Click on a patient’s name.
  2. Choose the tab holding the information you wish to view. 
  3. Click inside any box you wish to edit and update the information. 
  4. Select Save and Exit or Send Claim to save your changes.

Send a Claim to Insurance

  1. Click on a patient’s name.
  2. Select Send Claim to send the claim to insurance.

Delete a Claim

  1. Select the checkbox to the left of the claim(s) you wish to delete. 
  2. Click the dropdown arrow in the Actions column. 
  3. Select Delete and the claim(s) you selected will be deleted and removed.

Hold a Claim

  1. Click on the patient’s name. 
  2. Click the Hold button. 
  3. This will keep the claim in the Unsent tab and unable to be submitted to insurance until manually released.

Release a Claim

  1. Click on a patient that has a status of Hold. 
  2. Click the Release button. 
  3. The claim is now able to be submitted to insurance.

Add an Attachment

1.Click on the patient’s name on the claim you wish to add to the attachment. 

2. Select the Attachment tab. 

3. Select the method you wish to add your attachment.

a) Screen Capture
    1. Navigate to the image or screen you wish to capture.
    2. Click Start Capture.
    3. Using the crosshair your mouse has become, draw a box around the image beginning at the upper left corner to the lower right corner.
b) File Upload
    1. Drag & Drop Files to the displayed target area, or browse and select files, then click Upload.
c) Keyboard Capture
    1. Add images to your attachment with keyboard shortcuts using the following provided steps.
d) Image Sync
    1. View images for the selected patient.
    2. Select which attachments you want to add via the checkbox. 
    3. Click Add Images
    4. Images will show prelabeled.

4. After adding an image, the image must be labeled by choosing the Image Type. If an x-ray image type is selected, enter the Date Taken and Orientation.

a) If needed, you may also perform the following edits on the image:

    • Crop
    • Rotate
    • Flip
    • Brightness
    • Sharpness
    • Contrast

5. Once complete, click Save Image in the upper right corner or click Cancel to discard the image.

6. A thumbnail of the image will display with the option to Edit or Remove.

7. A Narrative (up to 2000 Characters) may be added to add additional descriptive information in support of the claim.

Ignore Attachment Requirements

  1. Click on the patient’s name to open the claim. 
  2. Select the Attachment tab. 
  3. If any attachments are required they will be shown at the top of the page in the Attachment Requirements section. 
  4. Click the Ignore button to the right of the requirements section. 
  5. This will ignore any attachment requirements that were holding the claim from being submitted.

Quick Actions

You may select individual claims using the checkbox to the left or use the select all option under Actions. The following Actions are available:

Select All

Checkbox selects all claims in the Unsent tab

Send

Sends all selected claims

Delete

Removes and deletes all selected claims

Hold

Holds claims in Unsent until Released

Release

Releases claims on hold

Ignore Attachment Req

Ignores Attachment Requirements for selected claims

Sent

The Sent tab displays claims that have already been submitted to insurance.

Default Columns:

Columns
Description

Actions

Mark Claim as Hidden/Mark Claim as Visible

Details

View/Edit/Resend Claims, View Electronic Remittance Advice and Attachments

Transmit Date

 

Patient Name

 

Subscriber Name

 

Carrier

 

Status

Accepted, Rejected, In Process, Printed, Duplicate

Status Description

Description and tooltips provide additional information on claim Status

The displayed columns are managed by selecting the column selector icon in the upper right corner of the page.

Sent Claim Actions

Mark as Hidden/Mark as Visible

This allows claims to be hidden or visible in the claim grid. 

  1. Select the claim(s) via the checkbox to the left under the details column. 
  2. Select the drop-down under the Details column. 
  3. Select Mark as Hidden/Mark as Visible depending upon the current status of the claim.

Hide Hidden Claims/ Show Hidden Claims in Claim Grid

Hidden claims are automatically removed from the claim grid so you do not see them. You may toggle this on or off.

1. Select Show Hidden Claims icon to show hidden claims in the claim grid.

2. Hidden claims are marked with a strikethrough so you know they have been marked as hidden.

Edit or Resend a Claim

  1. Click on a patient’s name.
  2. Choose the tab holding the information you wish to view. 
  3. Click inside any box you wish to edit and update the information. 
  4. Select Resend Claim to send your claim again to insurance.

View Previously Added Attachments

1. Select the patient’s name. 

2. Select the Attachment tab. 

3. Select the assigned NEA number and the attachment will open.

a) Here you can add a narrative to your attachment. 

b) You may also enter a Carrier Reference number if provided one from the insurance company.

4. Select Resend claim if you make any changes as they will not be saved.

Add New Attachments

1. Select the patient’s name. 

2. Select the Attachment tab. 

3. Select Create New Attachment.

a) If previous attachments were submitted a prompt will appear asking if you would like to include those in this resubmission.

4. See Add an Attachment for the remainder of the steps to add an attachment. 

5. Select Resend Claim to send your claim including attachments to insurance.

Print or Download

Select the associated icon at the top right of the page to print or download a CSV of the displayed claim information.

Filters

Sent Claims can easily be filtered to narrow down results.

Calendar

Use the calendar to narrow or expand your search criteria by date. Select the calendar and choose a present date filter or choose custom dates by clicking and dragging directly on the calendar.

Status Filters

Sent Claims may be filtered by claim status to easily find rejected claims that need attention. Quick filters are available for the most common status of Available and Rejected but you may also select the dropdown to choose any available status.

Column Filters

Any column with an available filter will have a magnifying glass icon to the right. Select the magnifying glass and you can enter what you would like to narrow that column down to.

Search

You may use the global search option to search any field. You may search multiple fields as well such as patient name and insurance name to narrow down results.

Claim Search

Search previously submitted claims through Vyne for up to two years and create a letter of timely filing that can be submitted to insurance.

1. Select the Archive Claim Search Icon in the Sent tab.

2. Search by patient name, subscriber name, insurance company, or tax ID to locate the claim(s). 

3. To generate a letter of timely filing, select the envelope icon under the action column.