A BRIEF SYNOPSIS OF HOW COMPLETE CLAIMS FUNCTIONS
Claim files produced by your practice management system go to a folder on your system, identified to Complete Claims where it waits to be transmitted to Availity or awaits further editing by Complete Claims. "Ready to Format"
If additional editing is done by Complete Claims, the files then are moved to a folder identified as "Ready to Send"
Once the claims are sent to Availity, they are immediately moved to "Waiting Responses".
All claims wait for a 997 from Availity to be returned. Once the 997 arrives the file is immediately moved to the "Sent and Archived" location, it verifies if there was a rejection at this level.
On the receipt of a reject in any response, 997, IBR, EBR or DPR the response errors are viewable from the "Responses" tab.
Current Upgrade Notes