Claims
Insurance aging and follow-up
Apart from a daily claim status inquiry, which runs only once the clearinghouse mailbox is connected, nothing chases a payer automatically, so aging is how unanswered claims are found. Two screens do it: Aging groups open claims by age and payer, and Follow-up lists the ones that need a person now.
Written for: Billing and RCM teams · Revenue cycle leadership
Aging
ArkCloud RCM → Insurance → Aging
| Field or control | What it means |
|---|---|
| Which claims | Open claims: Pending, Submitted, Acknowledged, In review and Partially paid. |
| Age from | The submission date; for a claim never submitted, its first date of service; failing both, when it was built. |
| Buckets | Current (dated today or later), 1-30, 31-60, 61-90 and over 90 days, overall and per payer. Filter by payer. |
| Amount | What the payer still owes: billed amount, minus what the payer has paid, minus adjustments, minus the patient's responsibility. Never shown below zero. |
Follow-up
ArkCloud RCM → Insurance → Follow-up
| Field or control | What it means |
|---|---|
| Submitted, no acknowledgement | Submitted more than 14 days ago with no 999 or 277CA. |
| Stuck in review | In review for more than 30 days. |
| Denied with an appeal deadline | Denied claims whose appeal deadline has not yet passed. |
| Partially paid | Waiting for a decision on the remaining balance: secondary, patient, appeal or adjustment. |
An administrator can mark items complete when worked (the button is shown only to roles that may do it). The completion is recorded in the audit trail and the item leaves the list. It comes back only if the claim changes again - a new status, payment or other update - and still needs follow-up. Calling the payer happens outside ArkCloud. Once the clearinghouse mailbox is connected, ArkCloud also sends a daily claim status inquiry (276) for claims still waiting 14 days after submission (see status tracking).
Patient balances
Patient account aging (AR Accounts, collections queues) is separate: a job at 02:00 each day moves each account into its aging bucket by the account's age. See the billing section.