What happens after I submit a claim?

For clinicians who have submitted a claim via our partner, ApexEDI, you will see the following in Charts>Billing>Transactions upon successful claim submission:

Once a claim has been paid, you will get a message within Luminello, from which you can go to the billing history directly.  There, you'll see the above entry get updated to:

And, you'll see a new entry to reflect the payment by the insurance company; in the comments, we'll also show you the patient responsibility.
If insurance has adjusted the claim (for example, a contractual adjustment), we'll show that to you in a separate entry.

Note that the following conditions must be met:

  • Your ERA paperwork with an individual payer must be in that payer's system (you'll do the paperwork when you sign up for Apex, but it could take up to 60 days to be processed) and you must actually receive an ERA via Apex.
  • Your claim must be paid.  To check the status of a claim, and/or to see if the insurance company has denied the claim, you'll need to go into your Apex portal.
  • Currently, we display all transactions in a running list; we do not group individual claim submission together.  This is currently in development.  If you'd like to be notified when this is available, let us know!

Please note: If a claim has been rejected, do not resubmit it through ApexEDI as it will not flow back to Luminello to update the patient's/client's transaction list once the process has been completed. Instead, please follow the steps below:

  1. Add a new billing transaction. Click here to learn how. 
  2. Submit a brand new claim through Luminello. Click here to learn how.

Questions? Contact us!

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