Status Feature on CMS 1500

Last updated: February 3, 2026

Osmind’s CMS 1500 includes a Status field that allows you to track where each insurance claim is in the billing process. Claim statuses may update automatically when Electronic Remittance Advice (ERA) data is received, or they can be updated manually by your team when needed.

This article explains how the CMS 1500 status feature works and what each status means.

Navigating to the CMS 1500 Page

To view CMS 1500 claims:

  1. Navigate to Billing from the left-hand menu

  2. Select CMS 1500

You will see a list of CMS 1500 claims, each with a corresponding Status column.

Understanding CMS 1500 Statuses

Each CMS 1500 includes a status that reflects its current position in the insurance workflow.

Not Sent

This status indicates that the CMS 1500 has been created but has not yet been submitted to the payer or clearinghouse.

Common reasons a claim may remain in this status include:

  • The claim has not yet been sent to a clearinghouse

  • Additional review or corrections are needed before submission

Sent

This status means the CMS 1500 has been submitted to the payer, typically through an integrated clearinghouse.

At this stage:

  • The claim is awaiting processing by the insurance company

  • No payment decision has been returned yet

Partially Paid

A CMS 1500 marked Partially Paid means the payer has issued a payment for part of the claim, but not the full billed amount.

This may occur when:

  • Certain services are covered while others are denied

  • Patient responsibility remains (e.g., deductible or coinsurance)

Fully Paid

This status indicates the CMS 1500 has been paid in full by the insurance company.

No additional insurance payment is expected for this claim.

Denied

A CMS 1500 is marked Denied when the insurance company has reviewed the claim and declined payment.

Denied claims typically require:

  • Reviewing the denial reason

  • Correcting claim information (if applicable)

  • Resubmitting or appealing the claim

Rejected

The Rejected status indicates the CMS 1500 was rejected before processing, usually by the clearinghouse or payer system.

Common reasons include:

  • Missing or invalid information

  • Formatting errors

  • Incorrect patient or provider data

Rejected claims must be corrected and resubmitted before they can be processed.

Manually Updating a CMS 1500 Status

If a CMS 1500 does not update automatically, you can manually adjust its status.

  1. Navigate to Billing → CMS 1500

  2. Open the CMS 1500 you want to update

  3. Locate the Status field

  4. Select the appropriate status from the dropdown

  5. Save your changes

Manual updates can be useful for internal tracking when external systems do not automatically update the claim.

Best Practices

  • Regularly review CMS 1500 claims to ensure statuses are accurate

  • Address Rejected claims promptly to avoid submission delays

  • Review Denied claims carefully to determine next steps

  • Use claim status to prioritize follow-up and billing work

Summary

The Status feature on CMS 1500 claims helps your practice track insurance billing progress from submission through payment. Whether a claim is not sent, sent, paid, denied, or rejected, keeping statuses accurate ensures better visibility and more efficient billing workflows in Osmind.