Claim Holds can be set at a practice, practice/payer, or practice/plan level, to delay primary claims from being sent to the clearing house. The delay is determined by the number of days set from the date of service.
Once a claim hold is created, during EDI processing, a check is run to determine if the claim should be held or if EDI should be generated.
If it is determined a claim is on hold, the Held field for the claim on the Manage > Claims page > Electronic Claims tab is automatically set to Yes.
After the claim completes the hold duration, the claim hold is automatically lifted at the end of the specified day and the claim moves forward with processing.
To override the claim holds functionality and force a held claim to the clearing house, complete a Mass Rebill activity on the claim. This generates a Rebill 2, which ignores the claim hold logic.
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