Every draft claim sits in Pre-Bill while it is checked against the payer's requirements. Nothing goes out until the checks pass.
Work the queue
Open Billing in the sidebar, under Admin. The page opens on the Pre-Bill tab; the tab badge counts claims ready to bill.
Under Pre-Bill Management, work the two queues:
Action Required — claims with at least one blocker. Start here.
Ready to Submit — claims that passed every check.
Each row names its blocker in Blocker / Reason. Timely Filing reads Expired in red once the deadline passes.
Start with Action Required and use the blocker column to decide which claim to resolve first.
Clear a claim's blockers
1. Click the row (or Resolve) to open the Claim Detail panel.
2. In Details, scroll to Prerequisites — every check, marked passed or failing, with a count such as Prerequisites (9/12).
3. Fix each failing check where it lives. Common ones:
Failing check | Where to fix it |
Patient demographics | Patient chart — name, date of birth |
Active Medicare coverage / valid MBI | Patient chart Financial tab — correct, then run a fresh eligibility check |
Service dates, service lines, claim totals | The claim's Line Items |
Primary diagnosis / HIPPS code | The episode's diagnosis and billing information |
SOC visit completed | Scheduling — confirm the SOC visit completed with time in and out |
NOA filing | NOA Management — see Keep NOAs on time |
Plan of care signature | Orders — complete the review and signature workflow |
Authorization coverage | The episode's authorizations — extend to cover every billed date |
Provider billing identity, payer claims ID, code library | Ask an administrator — these live in billing and payer setup |
Note: Hover the disabled Mark Ready to Submit button — the tooltip names exactly what is still blocking. If it does not identify a field you can fix, escalate to your billing lead. Rows marked Not applicable need no action.
4. Changes made inside the claim refresh the checklist automatically. Changes made elsewhere do not: return to the queue, refresh the browser page, and reopen the claim.
5. Complete the Manual pre-submit checklist below the details — the items only a person can confirm (for example NOA filed and accepted, Face-to-face encounter completed and documented). Tick each box after you confirm it.
Submit
Click Mark Ready to Submit at the bottom of the claim. It moves to Ready to Submit.
Open it there and click Submit Claim.
History tracks the submission, clearinghouse acknowledgment, and acceptance or rejection.
To pull a claim out of the flow, click Hold…, pick a reason (for example Pending documentation), and Release it later.
If something goes wrong
Timely filing already expired. The blocker cannot be cleared by editing the claim. Escalate to your billing lead.
Duplicate claim check fails. Search Pre-Bill and claim history for the same coverage window; void or replace the incorrect duplicate.
Line items are locked. The claim was submitted. Corrections go through the payer's replacement or void process.