About the Claim Warning Report

This report provides advance notice of claims that are likely to be rejected in the future. For example, if a payer announces they require a new data element for all claims on Jan. 1 of the coming year, the EDI support team immediately implements the edit for this data element as a warning. All claims that do not contain the data element, and would fail after Jan. 1, get the warning. When Jan. 1 arrives the warning edit is switched to a fatal edit, after which claims not containing the newly required data element fail. Included in the count are charges that have failed as well as those that will fail. By default, the report shows warning for the last seven days. Selecting the number hyperlink in the Claims Affected column displays the Claim Report with claims having that warning. The Payer column displays a list of payers for whom a specific edit is setup.

For this report to appear under eStatus, your system administrator must set the "Enable Claim Warning Report" preference to Y. Additionally, the user must have access to the report under User Management/Claims/Access Permissions.