| Icon | Icon Meaning | Where will icon appear? | Icon Definition |
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No Claim On File |
Issues Tab Open Tab |
Claim could not be found when searching the insurance portal for the claim. |
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Invalid Data |
Issues Tab Open Tab |
Claim contains incorrect information such as Policy ID #, Subscriber information, Patient information, or information was spelled incorrectly meaning the system was not able to match the claim when searching the insurance portal. |
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Info Requested |
Issues Tab Open Tab |
The insurance company is requesting additional information from the office to process the claim OR the claim has been put in a "Pended" status by Cigna. |
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Paid ZERO |
EOB Tab Claims Detail Page Open Tab |
The claim was completely denied by the insurance company. This is a FULL denial meaning all dental codes submitted on the claim were denied. |
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Paid UNDER Expected |
EOB Tab Claims Detail Page Open Tab |
The claim was paid less than the expected amount. This can be due to a partial denial (1 or more dental codes were denied on the claim, but not all dental codes were denied), fee schedule discrepancy, or claim contains downgrades/alternate benefits were applied. |
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Paid as Expected |
EOB Tab Claims Detail Page Open Tab |
The claim was paid in FULL (Paid 100% of the expected amount) for all dental codes on the claim. |
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Paid OVER Expected |
EOB Tab Claims Detail Page Open Tab |
The claim was paid more than the expected amount. This can be due to a fee schedule discrepancy, a claim that was combined with another by the insurance carrier, or alternate benefits being applied. |
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Login Issue |
Open Tab In Process Tabs Payor Portal Issues Tab |
When the system attempted to login to the insurance portal the portal returned an error for invalid username or password. This can also occur if 2 factor authentication failed during login. |
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Code Submitted from PMS |
Claims Detail Page Open Tab |
This code was submitted from the PMS and paid zero due to a downgrade/alternate benefit being applied (insurance company paid a different dental code than what was submitted). |
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Alternate Benefit Applied |
Claims Detail Page Open Tab |
The insurance company paid on this dental code instead of the original code that was submitted from the PMS (this is a downgrade/alternate benefit). |
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Claim In Process |
In Process Tab Open Tab |
The claim is newly transmitted and too early to check the insurance carrier OR the claim is lists as in process with the insurance carrier. |
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Claim not Supported |
Others Tab Open Tab |
The claim is on file in the PMS, however the InsideDesk system does NOT yet support the insurance portal to check for updates. |
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Paid Unknown |
Claims Detail Page Open Tab |
The insurance portal/EOB does not itemize the payment by dental code, meaning the system cannot determine the amount paid for each specific dental code. |
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Facility Issue |
Issues Tab Payor Portal Issues Tab Open Tab |
When accessing the portal with the credentials provided the login is not configured properly. The system was not able to select the correct office/tax id number for the claim or the login does not have proper permissions to access the information necessary to display in InsideDesk. |
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Retrying |
In Process Tab Open Tab |
When the system checked the insurance portal for the claim there was an error in the portal, the portal was down, or the system could not find a claim. This claim will be rechecked during the next evening batch cycle. |
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Portal Action Required |
Issues Tab Payor Portal Issues Tab Open Tab |
When the system accessed the insurance portal, the portal produced an error that requires action on the account owner's part like adding/verifying a tax ID, renewing provider credentialing, or updating/verifying an NPI number. |
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Paid Subscriber |
EOB Tab Open Tab |
The claim was paid by the insurance carrier, but made the payment directly to the subscriber instead of the office, this normally occurs due to the patient been seen by an Out-of-Network Provider. |
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Login Issue Due to 2-Factor Authentication |
Payor Portal Issues Tab Open Tab |
When the System Attempted to Login to the Payor Portal, the system could not authenticate due to 2 Factor authentication not being set up OR 2 Factor Authentication Expired. |
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Claim Batched Not Sent |
Claim Batch Not Sent Tab Open Tab |
This claim does not have a submission date meaning it was never transmitted to the Insurance Carrier. These claims may be waiting to be sent, or are secondary claims that were created and not yet sent to the insurance carrier due to waiting primary Insurance EOB. |
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Validation Error |
Issues Tab Open Tab |
The Clearinghouse has indicated there is a validation error with the claim, in order to take specific action please check the "Clearinghouse Notes" on the claim details page. |
| Claim BackLight Colors | Definition/Meaning | |
| Purple | Claim has received an update since the last time it was worked | |
| Green | Claim has been paid in FULL (paid 100% of the expected amount) for all dental codes on the claim | |
| Blue | Claim has been snoozed | |
| White | Claim is unread | |
| Gray | Claim is read | |
| Red | Claim is expired/greater than 365 days aged | |
| Yellow | Claim is expiring soon/305-365 days aged |
| Claim Details Page Claim Colors | Definition/Meaning | |
| Commercial Claim | HMO and PPO Claims | |
| Medicaid | State or Medical Assistance Claims | |
| Commercial Orthodontic Claim | HMO and PPO Orthodontic Claims | |
| Medicaid Orthodontic Claim | State/Medical Assistance Orthodontic Claims | |
| Claim Deleted | Claim was deleted from the PMS | |
| Claim Closed | Claim was posted and closed in the PMS |
| Claim Aged Color Indicators | Definition/Meaning | |
| <30 | Claim is Aged Less than 30 days from the Date of Service | |
| 30-89 | Claim has aged 30 to 89 days from the Date of Service | |
| 90-305 | Claim has aged 90 to 305 Days from the Date of Service | |
| 305-365 | Claim has aged 305-365 Days from the Date of Service | |
| >365 | Claim has aged Over 365 from the Date of Service |