Foundation only. No clearinghouse, ERA/EOB import, or real claim submission. All queues use placeholder data from web/src/lib/claims-operations/. Intended roles: Billing Company Admin, Supervisor, Biller, Coding User, Customer Service.
Filters
Demo KPIs — no claims tables in CRM yet. Counts reflect filtered placeholder data.
Claims Submitted Today
0
Claims Pending
2
Claims Rejected
2
Claims Denied
2
AR Over 90 Days
3
Follow-Up Tasks
3
Claim status queue
Submitted, pending, and paid claims in the active pipeline
| Claim # | Patient | DOS | Provider | Payer | Balance | Status | Assigned To | Last Follow-Up | Priority | Actions |
|---|---|---|---|---|---|---|---|---|---|---|
| CLM-2026-10482 | J. Martinez | 2026-09-12 | Dr. Maria Chen | Aetna PPO | $284.50 | Submitted | Renee B. | — | normal | |
| CLM-2026-10471 | A. Thompson | 2026-09-09 | Dr. Maria Chen | Medicare | $1,200.00 | Pending | Mike T. | 2026-09-11 | high | |
| CLM-2026-10110 | S. Nguyen | 2026-09-06 | Dr. Jordan Patel | Cigna | $0.00 | Paid | Renee B. | 2026-09-12 | low | |
| CLM-2026-10501 | P. Garcia | 2026-09-13 | Dr. Sam Lee | Medicaid | $178.00 | Submitted | Mike T. | — | normal | |
| CLM-2026-10410 | M. Foster | 2026-09-02 | Dr. Jordan Patel | Medicare | $620.00 | Pending | Mike T. | 2026-09-09 | normal |
Denials queue
Denied claims requiring appeal or write-off decision
| Claim # | Patient | DOS | Provider | Payer | Balance | Status | Assigned To | Last Follow-Up | Priority | Actions |
|---|---|---|---|---|---|---|---|---|---|---|
| CLM-2026-10244 | K. Davis | 2026-08-03 | Dr. Ana Ortiz | United Healthcare | $892.00 | Denied | Mike T. | 2026-09-07 | high | |
| CLM-2026-09902 | T. Allen | 2026-07-21 | Dr. Ana Ortiz | Aetna HMO | $1,540.00 | Denied | Renee B. | 2026-09-10 | urgent |
Aging claims queue
Open AR over 90 days
| Claim # | Patient | DOS | Provider | Payer | Balance | Status | Assigned To | Last Follow-Up | Priority | Actions |
|---|---|---|---|---|---|---|---|---|---|---|
| CLM-2026-10244 | K. Davis | 2026-08-03 | Dr. Ana Ortiz | United Healthcare | $892.00 | Denied | Mike T. | 2026-09-07 | high | |
| CLM-2026-10088 | L. Brooks | 2026-08-14 | Dr. Maria Chen | Humana | $310.25 | Follow-Up Needed | — | 2026-08-31 | urgent | |
| CLM-2026-09902 | T. Allen | 2026-07-21 | Dr. Ana Ortiz | Aetna HMO | $1,540.00 | Denied | Renee B. | 2026-09-10 | urgent |
Missing documentation queue
Claims blocked until clinical or billing documents are received
| Claim # | Patient | DOS | Provider | Payer | Balance | Status | Assigned To | Last Follow-Up | Priority | Actions |
|---|---|---|---|---|---|---|---|---|---|---|
| CLM-2026-10390 | R. Wilson | 2026-08-27 | Dr. Sam Lee | BCBS | $456.75 | Rejected | Renee B. | 2026-09-13 | urgent | |
| CLM-2026-10088 | L. Brooks | 2026-08-14 | Dr. Maria Chen | Humana | $310.25 | Follow-Up Needed | — | 2026-08-31 | urgent | |
| CLM-2026-10410 | M. Foster | 2026-09-02 | Dr. Jordan Patel | Medicare | $620.00 | Pending | Mike T. | 2026-09-09 | normal |
Follow-up tasks queue
Rejected or follow-up-needed claims
| Claim # | Patient | DOS | Provider | Payer | Balance | Status | Assigned To | Last Follow-Up | Priority | Actions |
|---|---|---|---|---|---|---|---|---|---|---|
| CLM-2026-10390 | R. Wilson | 2026-08-27 | Dr. Sam Lee | BCBS | $456.75 | Rejected | Renee B. | 2026-09-13 | urgent | |
| CLM-2026-10088 | L. Brooks | 2026-08-14 | Dr. Maria Chen | Humana | $310.25 | Follow-Up Needed | — | 2026-08-31 | urgent | |
| CLM-2026-10355 | E. Wright | 2026-08-23 | Dr. Sam Lee | BCBS | $95.50 | Rejected | — | 2026-09-05 | high |
Recent activity
Demo timeline — future: polymorphic activities + claim audit logs.
Denial appeal drafted
CLM-2026-10244 — medical necessity letter queued for supervisor review.
Sep 14, 3:43 AM · CLM-2026-10244 · Valley Ortho Group
Claim batch submitted
12 professional claims submitted to clearinghouse (demo).
Sep 14, 2:43 AM · Sunrise Family Care
Follow-up call logged
CLM-2026-10088 — payer line busy; retry scheduled.
Sep 13, 4:43 AM · CLM-2026-10088 · Sunrise Family Care
Missing operative note requested
CLM-2026-10390 — document request sent to practice.
Sep 12, 4:43 AM · CLM-2026-10390 · Lakeside Pediatrics