Once a claim leaves Pabau it is out of your hands but not out of your sight. The claims dashboard keeps every submission's current state, pulls updates back from Claim.MD and the payer, and records each step so you can see exactly where a claim stalled and why.
NOTE: Insurance billing is currently available for practices in the United States. Claims are submitted electronically through the Claim.MD clearinghouse.
Step 1: Find Your Claims
Go to Money → Claims. The dashboard opens on the last 90 days, and every invoice issued to an insurer is listed whether or not it has been submitted yet.
Three controls narrow the list:
- The tiles across the top - All claims, Pending, Submitted, Processing, Paid and Needs action. Each shows a count and the amount still owed; clicking one filters the table to it.
- The period menu - Today, Yesterday, Last 7 / 14 / 30 / 90 / 180 days, or a custom range.
- The search box, which matches on claim number, client name and authorisation code.
Step 2: Read the Status Column
Each row's Status cell carries two pieces of information. The badge is the invoice's billing state. Underneath it, with a coloured dot, is the claim's own state at Claim.MD, followed by how long ago it was last checked.
Pabau tracks each claim through seven states:
| Status | What it means | What to do |
|---|---|---|
| Draft | The invoice is issued to an insurer but the claim has not been worked yet. | Open it, fill in what the visit did not supply, and send. |
| Ready to submit | Validation passed - the claim is clean and waiting to be sent. | Send it, on its own or as part of a batch. |
| Submitted | Accepted by Claim.MD and forwarded to the payer. Awaiting adjudication. | Nothing. Sync occasionally and wait for the payer. |
| Held | Claim.MD has the claim but is holding it until the document it declares arrives. Nothing has been refused and no payer has seen it yet. | Usually nothing - it transmits on its own once the note lands. If it sits there, press Send again to retry the same document. |
| Rejected | Stopped before adjudication, by Claim.MD or the payer's front end. | Fix the fields named on the claim, re-validate, and send again. |
| Denied | Adjudicated and not paid. | Review the payer's reason codes, then correct and resubmit - or appeal. |
| Paid | The remittance arrived and payment was posted against the invoice. | Nothing. Bill any secondary payer from the claim screen. |
NOTE: Held is a pause, not a refusal. A held claim is parked at Claim.MD waiting for its attachment - it never reached the payer, which is why no payment can be recorded against it until it moves on.
Step 3: Pull the Latest Updates
Statuses refresh from Claim.MD rather than changing on their own, so a status is only ever as current as its last check. Two ways to refresh:
- The sync icon beside a claim's status - updates that one claim.
- Sync on the dashboard - pulls everything Claim.MD has since the last check, including rejections and payer updates that arrived overnight.
The synced timestamp under each status tells you how stale the row is. A claim that has not been checked for days is not necessarily stuck; it just has not been asked recently.
Step 4: Read a Claim's History
Every validation, submission, rejection reason and payer update is recorded against the claim. Open the history with the clock icon in the claim header to see the sequence with timestamps - which is usually the fastest way to answer "when did this go out, and what came back".
Step 5: Submit Several Claims at Once
When a batch of visits is ready to bill, you do not have to open each claim:
- Tick the claims you want to send. The checkbox at the top of the column selects every sendable claim on the page.
- A bar appears showing how many are selected. Click Submit selected.
- Pabau validates each claim, sends the ones that pass as a single batch, and reports how many went and how many need attention.
A claim that fails validation is left out of the batch with its reason listed, rather than stopping the others from going. Claims carrying a chart note are sent individually instead, because Claim.MD holds an attachment claim until its document arrives.
Claims that cannot be batched have their checkbox disabled, so the selection only ever contains claims a batch can actually send.
IMPORTANT: Batch send covers first submissions only - Draft and Ready to submit. A claim you have already sent and corrected is resubmitted from the claim screen, where your edits are kept. Batches are capped at 50 claims; select more and Pabau asks you to split them rather than sending a partial batch.
Step 6: When a Claim Stops Moving
A claim that has not changed state in a while is usually one of three things:
- Still Draft - it was never sent. Nothing is wrong; it is waiting for you.
- Held - the attachment has not arrived. Press Send again on the claim to retry with the same document.
- Submitted for an unusually long time - run a sync first, since the payer's update may already be waiting at Claim.MD. If it is genuinely silent, the claim's history has the technical reference to quote to support.
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For more guides, browse the related articles below or use the search bar at the top of the page. You can also watch our video learning series, the Pabau Academy, or visit the Support page for additional help.