You can place both providers and claims on hold independently of each other. For more information about provider holds, see Place Providers on Hold. If you place a claim on hold, that claim cannot be paid and is excluded from all sate claim reports/automated state claim transfer files.
If the provider is on hold and you process a claim for that provider, the claim is automatically placed on hold. When manually entering claims, you can choose to place the claim on hold.
To review claims on hold:
- From the menu to the left, click Claims then select On Hold Claims. The One Hold Claims page opens.
- Use the Find Records section to filter the results by month and provider.
- Click
and the results load based on your filter selections.
- To put a claim on hold, use the checkbox to the right of the Date On Hold field for the provider and select the date the provider went on hold.
- Click the Reason drop-down menu and select the hold reason. You create hold reasons in the Hold Reasons window. For more information, see Edit Hold Reasons.
- Click Save.
To remove claims from hold:
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In the On Hold Claims window, clear the box next to the Date On Hold box by unchecking the checkbox. The claim is removed from hold, and the current date populates the Date Off Hold box. Edit the date as needed.
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Click Save.