Claims that have not been rejected by the clearinghouse or the payer will move automatically to the Accepted Bin, once the associated report is downloaded. This will only occur for claims sent through the MacPractice partner clearinghouse, Change Healthcare.
It is possible for a payer to reject a claim that has been accepted and sent along by the clearinghouse. If an eClaim is accepted by the clearinghouse, it will move to the Accepted Bin. If a subsequent report comes in for that same claim from the payer that indicates a rejection, the claim will then move to the Rejected Bin.
A status of "Accepted" from the clearinghouse does not automatically guarantee that the claim will be accepted at the payer. A status of "Accepted" from the payer does not mean that the payer is guaranteed to pay on the claim. The "Accepted" status only means that the claim met all technical criteria to be processed at the current entity and sent on in the next stage of processing.
If a claim has been in the Accepted Bin for more than ten business days, and no payment has been received for the claim, it is important that the office call the payer to follow up on the claim. MacPractice cannot research a claim that has been sent more than 30 days ago, so it is important that any problem claims be addressed as soon as possible.