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Documentation Index

Fetch the complete documentation index at: https://docs.encoreos.io/llms.txt

Use this file to discover all available pages before exploring further.

The Claim Details screen displays a single claim with tabbed sub-views and a full set of status-action controls at route /pm/claims/:claimId.

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Overview

The page loads a claim via useClaimDetail. A four-card summary row shows Total Charge, Paid, Adjustment, and Patient Responsibility amounts. A ClaimLineagePanel renders claim lineage. If denial_codes are present, they appear above the tabs via DenialCodeDisplay. The tabbed interface provides: Lines (claim line items with CPT, modifiers, units, date, charge/paid amounts), Scrub (on-demand client-side claim scrubbing via scrubClaim() — requires pm.claims.update), Notes (note form + list), Denials (linked denials via ClaimDenialSummaryPanel), and Secondary Claims (requires pm.cob.view). For institutional claims (claim_type === 'institutional_837i'), additional UB-04 Details, Preview 837I, and Generate 837I actions appear in the header when the user has PM_PERMISSIONS.INSTITUTIONAL_CLAIMS_GENERATE_837I. Void and Create Replacement actions appear based on claim status and pm.claims.void permission.

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Who it’s for

Requires permission PM_PERMISSIONS.CLAIMS_VIEW (enforced via RequirePermission in the route definition). Additional permissions:
  • pm.claims.update — Run scrubbing, add notes
  • pm.claims.void — Void or replace claims
  • pm.cob.view — Secondary Claims tab
  • pm.institutional_claims.generate_837i — Generate/Preview 837I
  • pm.institutional_claims.update — UB-04 Details

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Before you start

  • You need pm.claims.view to access this page.
  • Navigate here from the Claims list (/pm/claims).

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Steps

1

Open a claim record

From the Claims list (/pm/claims), click a claim row to open the detail page.
2

Review summary totals

The four summary cards show Total Charge, Paid, Adjustment, and Patient Responsibility.
3

Review claim lines

The Lines tab lists each claim line with CPT code, modifiers, units, service date, charge amount, and paid amount.
4

Run claim scrubbing

On the Scrub tab, click Run Scrubbing (requires pm.claims.update) to execute client-side validation against configured scrub rules.
5

Add or review notes

The Notes tab shows existing claim notes and a form to add new notes (requires pm.claims.update).
6

Review linked denials

The Denials tab shows denial records associated with this claim via ClaimDenialSummaryPanel.
7

Take status actions

Use the status menu or Void / Create Replacement buttons in the header based on your permissions.

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Key concepts

TermMeaning in code
claim_numberDisplay identifier for the claim
claim_typeE.g., institutional_837i enables UB-04 and 837I generation
denial_codesArray of denial/adjustment codes on the claim
CLAIM_NOTE_TYPE_LABELSLabels for note type categories
CLAIM_TYPE_LABELSDisplay labels for claim types
Voidable statusesdraft, scrubbed, submitted, accepted, denied, appealed, adjusted
Replaceable statusesvoid, adjusted

Practice Management

Practice Management core overview.

Governance & parity

Documentation coverage and governance.
This page documents shipped product behavior. It is not medical, legal, or billing advice. Verify against your organization’s policies and applicable regulations before using it for clinical, compliance, or billing decisions. Protected health information (PHI) shown in the product is governed by your tenant’s access controls and is never exposed in this documentation.
  • src/routes/pm.tsx
  • src/cores/pm/pages/ClaimDetailPage.tsx
  • src/cores/pm/hooks/useClaimDetail.ts
  • src/cores/pm/utils/claim-scrubbing.ts