For billing staff at practices in the posting-queue pilot
What changed
MedFlow now checks the status of filed claims with payers on a schedule, instead of only when someone clicks Check Claim Status on a claim. When a payer's answer says a claim was paid, denied or revised, MedFlow turns it into a posting plan: the transactions it would post against the claim's service lines.
Nothing posts on its own. Every plan waits in the Posting Queue under Billing until a person approves or rejects it. Two things follow from that:
Clean payment plans can be approved in one click, singly or all at once. A plan is clean when it is a payment, every dollar is matched to a service line, and nothing was skipped.
Everything else waits in a review lane. Denials, adjustments, plans with unmatched amounts, and plans where part of the response could not be used need a person to read them.
Rejecting a plan does not stop the checks; the claim keeps being re-checked on the normal schedule.
1. Before you start
The Posting Queue menu item appears under Billing once MedFlow turns it on for your practice.
Viewing the queue needs the Claim status approvals: read permission; approving and rejecting need update. Both come with the practice owner, admin, manager, medical biller, provider, accounting and base roles. Without update you can read every plan but will see no Approve or Reject buttons.
Posting plans write transactions the same way the Post Transaction form does. If you have not read the posting guide, read its sections on transaction types and line allocations first.
2. Reading the queue
Open Billing → Posting Queue.
Across the top:
Element | What it tells you |
Needs attention | How many plans wait in the review lane and their total planned amount |
Ready to approve | How many clean payment plans wait, and their total |
Oldest pending | How long the oldest waiting plan has been there |
Practice selector | Narrows the queue to one practice if you work several |
Three tabs: Needs attention, Ready to approve, and History. The counts on the tabs match the strip.
If the queue holds more than five hundred pending plans you will see Queue exceeds 500 pending plans (N total) — showing the first 500. Tighten the organization filter to see the rest.
3. The lane tables
Both lanes list one plan per row.
Column | Meaning |
Claim # | The claim the plan belongs to |
Patient | The patient on the claim |
Payer priority | Primary, secondary or tertiary insurance |
Plan type (Needs attention only) | payment, denial, adjustment, or status only |
Planned amount | The total the plan would post |
Unallocated (Needs attention only) | Money in the payer's response that matched no service line |
Origin | poller for a scheduled check, manual check for one a person started |
Age | Time since the plan was created |
A row marked applying is being posted right now and cannot be opened.
Empty lanes say so: Nothing waiting for rubber-stamp in Ready to approve, No plans need attention in Needs attention.
4. Approving clean plans
In Ready to approve, each row has an Approve button. Clicking it posts that plan. The toast reads Applied posting plan for claim <claim #>.
To post every clean plan at once, click Approve all (N) · $total. A dialog titled Approve all clean plans says This posts N payment plan(s) totaling $X. Plans that fail stay in the queue. Confirm with the same button.
Afterwards a toast reports the outcome: Approved N plan(s), or, when some could not post, which claims failed to approve and which need over-allowable confirmation — open the plan to approve. Plans that did not post stay in the queue; nothing is lost.
5. Reviewing a plan
Click any row in either lane. A panel slides in with the claim number as its title, a View claim link, and Previous plan / Next plan arrows (also the ↑ / ↓ or k / j keys) so you can work down the lane without closing it.
The panel shows:
Payer Claim # and Date from the payer's response.
Each planned transaction with its type badge (payment, denial, adjustment) and amount, then the matched service lines with procedure code, units and amount. A line the payer reported that matches none of ours shows as Unmatched line.
Skipped: parts of the response MedFlow could not turn into a transaction, with a count per reason.
Total amount: and Unallocated: at the bottom.
A plan with no postable transactions says No postable transactions in the response. Nothing will be written — click Reject to dismiss this review.
Approve
Approve posts the plan and moves to the next one. If a paid amount is above the line's allowable, a dialog titled Paid amount is greater than allowable explains One or more line amounts exceed the allowable. Confirm to post anyway. This does not update the claim's allowed amounts. Choose Approve anyway or Go back.
Reject
Reject opens Reject Posting Plan: Provide a reason for rejecting this plan. The claim stays in the queue and continues to be re-checked on the normal polling schedule. Type the reason (required, up to 500 characters) and click Reject Plan. The toast reads Rejected posting plan for claim <claim #>.
Reject when the response is wrong for this claim, when you have already posted the payment by hand, or when the plan would post to the wrong lines. Add the reason you would want to read in six months.
6. History
The History tab lists decided plans: Applied, Rejected and Superseded (a newer response replaced the plan before anyone acted). Filter by Status and Origin; each row has a View link to the claim. Twenty-five rows per page.
7. On the Billing Claims list
Two additions help you see what the checks are doing:
A Last checked column: when the payer last answered for the claim.
A Status check filter with Scheduled, Not found, Stale, Unsupported and Exhausted. Not found means the payer did not recognise the claim; Stale means no answer in thirty days; Exhausted means MedFlow stopped checking after eighteen months.
Worked example
Monday morning the strip reads Needs attention 3 · $0.00 and Ready to approve 3 · $9,724.19. In Ready to approve every row is a payment plan with nothing unallocated. You click Approve all (3) · $9,724.19, confirm, and the toast says Approved 3 plan(s). Each of those claims now carries a payment transaction, and their balances and statuses update exactly as if you had posted by hand.
In Needs attention the three rows are denials with a planned amount of $0. You open the first: two lines, both F2 — Denied, no skipped reasons. The denial is right, so you Approve; the claim gets a denial transaction with its reason codes. The second plan shows Unmatched line for a procedure code the claim does not carry. You Reject with the reason Payer response references A6219, not on this claim; opened with payer, and the claim stays on the schedule.
Corrections
Approved the wrong plan: posted transactions cannot be deleted. Post an offsetting transaction from the claim's Transactions tab, as the posting guide describes, and add a note.
Rejected by mistake: the claim is still checked on schedule; the next response creates a new plan. To act sooner, run Check Claim Status on the claim.
A plan is stuck at applying: wait a minute and refresh. If it stays, tell MedFlow support with the claim number.
Quick reference
Lane | Contains | Action |
Ready to approve | Payment plans, fully matched, nothing skipped | Approve per row or Approve all |
Needs attention | Denials, adjustments, status-only, unmatched amounts, skipped parts | Open, read, Approve or Reject |
History | Applied, rejected, superseded | Read; View the claim |
Rules that will stop you
Reject needs a reason, 1 to 500 characters.
Approve all posts at most fifty plans per click.
A plan with no postable transactions cannot be approved; reject it.
Over-allowable amounts need Approve anyway.
Questions
Contact the MedFlow billing team.