Why is a claim stuck in Pre-Bill? Open the claim and read Prerequisites in the Details section — every check is marked passed or failing. Hover the disabled Mark Ready to Submit button for the exact blocker. See Get claims ready in pre-bill.

A fix was made in the chart but the claim still shows the blocker. Changes made outside the claim do not refresh it live. Return to the queue, refresh the browser page, and reopen the claim.

Can line items be edited after submission? No — line items lock at submission. Corrections go through the payer's replacement or void process.

What is the manual pre-submit checklist? The items no system can verify for you — NOA accepted, face-to-face documented, plan of care signed, all billable visits included. Tick each box after you confirm it; the claim will not go out until the checklist is complete.

When is an NOA due? Medicare requires an accepted NOA within five calendar days of the start of care. The queue shows the day count and turns it into a red badge (for example Day 7/5) when late. Late filing reduces payment for the period. See Keep NOAs on time.

Do I submit NOAs myself? Usually not — once every prerequisite passes, submission is automatic. Step in when a prerequisite fails or Medicare rejects.

Can the NOA go out before the start-of-care documentation is finished? Yes. The NOA can be submitted once the SOC visit is completed with patient time in and out — it is not held for full OASIS completion. NOA submission is a billing task, not a clinical one.

Why is Resubmit disabled on a rejected NOA? Tick I have reviewed and corrected this rejection first, and make sure the prerequisites pass again.

Does eligibility run automatically? Yes, when the referral's payer matches your payer list (aliases handle spelling differences). Results older than 72 hours show Stale — run a fresh check before billing.

How do authorization limits affect visits? The authorization binds the schedule. Visits beyond the authorized units are not plotted without an updated order. Watch the used/allowed counts (for example SN: 4/12) on the patient's Authorizations section, and the Insufficient Authorizations report across patients.

Can one claim carry multiple authorization numbers? Yes. Authorization requirements are payer-driven — when a payer requires authorization, the claim includes every applicable authorization number for the billing period, so state-plan and waiver hours with separate numbers bill together.

How is a Medicare pre-claim review (PCR) handled? Through authorizations: create a billing-period authorization and enter the UTN (Unique Tracking Number) as the authorization number. The claim carries it from there.

Why won't a remittance post? Every claim on it must be Matched or Excluded, and Check Balance must be zero. Hover the disabled button for the specific blockers. See Post a remittance.

A payment was short. Where do I look? Expand the claim row on the remittance — the payer's adjustment group, code, and description usually explain the difference.

Can a posted remittance be corrected? No. Posting writes to the A/R ledger and cannot be undone; the remittance becomes read-only. Corrections happen through new transactions.