Claim line statuses in Smart Claims Engine are displayed on the claim line and also in the claim line details section of the claim.
Claim line statuses are a single word indicating the status of the individual claim line. Claim line statuses include:
|Claim line status||Definition|
|New||This is the initial status of claim lines and it indicates the line has not yet been adjudicated.|
|Pending||This status is assigned when the claim line has generated an event code which requires additional processing or examiner intervention.|
This status indicates that the service billed by the provider is disallowed.
|Approved||This status is set when the service billed by the provider is allowed.|
|Paid||This status is assigned when the service billed by the provider is approved and payment batch has been completed.|
|Voided||SCE assigns this status when the claim line has been invalidated or “backed out”. All associated accumulators are reversed.|
|Cancelled||SCE assigns this status when the claim line has been annulled; this is also the status applied to an original claim line when it has been split into two or more claim lines.|