Who this is for: All Barti RCM practices.
Claim statuses: what they mean
Draft — the claim is incomplete. The RCM team will not review or submit claims in Draft status.
Hold — the claim is ready for the RCM team. Setting a claim to Hold signals the team to begin processing. Claims are typically submitted within 2 business days.
What happens after a claim is placed on Hold
An RCM Billing Specialist reviews and scrubs the claim.
The claim is filed with the payer through TriZetto.
If the claim is denied or rejected, the RCM team addresses it. Denials and rejections are reviewed and worked weekly.
All actions taken on a claim are documented in the claim's internal notes, visible from the claims table or from within the specific claim.
If the RCM team needs information from your office
If additional information is required to process or appeal a claim, the RCM team will add a task in Barti for your designated RCM contact. Respond to tasks promptly — delays in providing information can lead to claim delays or denials. Tasks sent to the RCM team are addressed within 2 business days.
What you'll see when it works
The claim moves from Hold through processing. If a claim is resubmitted after a denial, an internal note is added to the claim reflecting the action taken.
Troubleshooting
My claim has been in Hold for more than 2 business days and hasn't been submitted.
Contact the RCM team at rcm@barti.com. Include the patient name and claim details, and mark your email URGENT if needed.
A claim was denied. What happens next?
The RCM team reviews all denials weekly and will work the denial on your behalf. If they need anything from your office, they'll create a task in Barti for your RCM contact. You don't need to take action unless you receive a task.
Can I edit a claim after it's been placed on Hold?
Yes, a claim can be edited after it's been put on Hold. You'll see Save Draft and Save & Hold in the top right hand corner of the claim, make sure you click one after making the appropriate edits. However, once the claim is submitted to TriZetto, the status will change to Pending and will automatically update.