Sometimes a chart arrives that you cannot bill as-is: a signature is missing, the narrative does not support medical necessity, or the insurance information is wrong. Instead of chasing the crew by phone or email, flag the claim back to the agency. The crew answers the flag in their ePCR, and the corrected chart comes back to you automatically.

Before you start: Flagging works for charts that came from CloudPCR, because that is where the crew answers the flag. If you do not see the Flag for Agency Correction button on a claim, the chart came from another source.

How to flag a claim

  1. From the menu, click Claims, then click the claim's row to open it.
  2. At the top of the claim page, click Flag for Agency Correction.
  3. The Flag this chart for correction form opens. The agency receives what you enter here as a billing flag to fix and resubmit.
  4. Under What needs correcting?, pick a category: Documentation incomplete, Missing signature, Patient demographics, Insurance / payer information, Medical necessity / narrative, Coding clarification needed, or Other.
  5. Under Details for the agency, describe specifically what the crew needs to add or correct. Be concrete: "The patient signature on page 2 is blank" gets fixed faster than "signature problem."
  6. Click Send to Agency.

The claim locks with a banner reading Locked - sent to agency for correction, and its status changes to Flagged - Sent to Agency. You are done with it until the crew responds.

What the agency sees and what comes back

An administrator at the agency sees your flag on the chart in CloudPCR, with your category as the heading and your details underneath. They can answer it themselves or pass it to the crew member who ran the call, who writes the answer and sends it back to their administrator for review. Either way, the chart is fixed, the flag is answered, and the chart is resubmitted. When the corrected chart arrives, the lock releases on its own, the status changes to Agency Corrected, the claim lands back in your working queue, and it drops off the Flagged Trips tile. A blue summary on the claim lists every change since you last reviewed it; click Acknowledge once you have looked it over.

Flag history

Every flagged claim gets a Flag history toggle at the top of the page, with a count of flags raised. Click it to expand the full conversation: each of your flags with its category, details, and time, and the agency's answer underneath, or "Awaiting agency response" if they have not replied yet.

If you need the claim back sooner

If the crew is slow to respond and you need to work the claim now, click Unlock on the lock banner. Taking a flagged chart back this way moves it to Agency Corrected so it returns to your review flow.

Example

A transport for Marcus Webb comes in without a patient signature. You open the claim, click Flag for Agency Correction, pick Missing signature, and write "Patient signature is blank. Please capture the patient or authorized representative signature and resubmit." You click Send to Agency and move to the next claim. Two days later the claim is back in your queue as Agency Corrected, the flag history shows the crew's answer, and the signed chart is ready to bill.

Tips

  • One clear flag beats three vague ones. Spell out exactly which field, page, or section needs fixing.
  • Flags for correction are separate from QA flags, which your QA reviewers use before billing. See QA flags on a claim.
  • The statuses this workflow drives are covered in Claim statuses.