This article explains how to open a claim in MedMe and read its details, payment breakdown, and remittances. It covers the summary shown on every tab and what each tab contains.
Table of Contents
Overview
The Claim Details modal is the read-only view of a claim. It shows what was submitted, the payer's response, and any payments received, without opening the claim for editing.
Opening the Claim Details Modal
Select a claim row in any of these places:
The Claims page.
The Claims card on the patient's Billing tab.
The Claims card on an appointment's tab.
Or open the row's ⋯ menu and select View Details. Close the modal with X or Esc.
Please Note: Draft claims do not have a Claim Details view because they have not been submitted. Selecting a draft opens it in the Edit Claim modal instead.
The Summary Band
The title shows Claim # followed by the claim identifier and the claim's status chip. Under it, on every tab:
Patient — select the name to open the patient's profile on the Billing tab.
Date of Service — the service date of the claim.
Linked Entity — the appointment the claim is for; select it to open the appointment.
Submitted Date and Submitted By — when and by whom the claim was sent. Show a dash for Draft and Ready for Submission claims.
Total Billed — the sum of the service line charges.
Total Paid — the total paid by the payer; a dash until a remittance arrives.
Overview Tab
The Overview tab shows the payer section and the payment breakdown.
The payer's name with the payer-level status chip.
For a Rejected claim, the rejection reason returned by the clearinghouse or payer in plain language.
Payment Details — one row per service line with Service Line (the CPT / HCPCS code), Billed, Allowed, Paid, and Patient Resp. (the amount the payer assigned to the patient), followed by a Total row. Allowed, Paid, and Patient Resp. show a dash until the claim is adjudicated.
See Remittances — appears once at least one remittance has been received and switches to the Remittances tab.
Details Tab
The Details tab shows the claim exactly as it was submitted:
Rendering Provider, Billing Provider, and Referring Provider — provider name, NPI, taxonomy, and TIN / EIN for the billing provider.
Payer — payer name, member ID, subscriber, relationship, and date of birth as they were on the insurance at submission time.
Claim — place of service and the full list of diagnosis codes.
Service 1, Service 2 … — for each line: Ref ID, CPT code, ICD codes, modifiers, units, billed, and paid amounts.
Please Note: The Details tab is a snapshot. If the patient's insurance or a provider is edited after the claim was submitted, the claim still shows the values that were sent to the payer.
Remittances Tab
The Remittances tab lists the electronic remittance advice (ERA / 835) received from the payer.
A summary row with # Remittances and Total Paid.
One section per remittance with the payer, check number, date, number of lines, and amount.
Line items for each remittance with the DOS (date of service), CPT, Allowed, and Paid amounts.
Until the payer responds, the tab shows This claim doesn't have any remittances yet. Draft, Ready for Submission, Submitted, and Accepted claims will always show this message.
Tip: For a Partially Paid or Denied claim, compare the line items here with the Payment Details on the Overview tab to see which lines were not paid before editing and resubmitting.
Activity Tab
The Activity tab is the history of the claim, newest first. Each entry shows what happened, who did it, and the date and time in the pharmacy’s time zone. Entries that changed the claim’s status show the change as two chips (for example Submitted → Rejected).
The Activity tab records:
Claim created: who created the claim.
Submitted and Resubmitted: who submitted the claim. There is one entry each time it is sent.
Clearinghouse responses: when the claim was received, accepted, or forwarded to the payer, or rejected before reaching the payer.
Payer responses: when the payer accepted or rejected the claim.
Payments: one entry per remittance, with the patient responsibility and the check / EFT trace number. See the Remittances tab for the amount paid.
Voided: who voided the claim.
Rejection and denial entries show the reason in the same wording as the Overview tab. Each entry shows the reason for that rejection, so a claim rejected more than once keeps every reason.
Each entry names who did it:
A pharmacy team member: their name and role.
MedMe: automated events.
Clearinghouse: responses received before the claim reaches the payer.
The payer: the payer’s name, for example Medicare Part B.
Please Note: The Activity tab records events, not edits. Changes made to a draft, or edits made while correcting a rejected or denied claim, do not appear as their own entries. The next entry appears when the claim is submitted or resubmitted. Undo Submission is not recorded either.
Troubleshooting
Total Paid and the Paid column show a dash. No remittance has been received. Check back after the payer adjudicates the claim.
The payer paid, but no remittance appears. Remittances only arrive electronically when the pharmacy's ERA enrolment with that payer is complete. Contact the MedMe RCM team.
The Details tab shows a provider marked (deleted). The provider was removed from the pharmacy's provider list after this claim was created. The claim still holds the submitted name and NPI.
I need to change something I see on the Details tab. Close the modal and use Edit from the claim's ⋯ menu. Editing is only available for Rejected, Denied, and Partially Paid claims (and drafts, which open in Edit Claim directly).
I edited a claim but the change isn’t on the Activity tab. Edits are not recorded as their own entries. The claim gets a new entry when it is submitted or resubmitted.
An entry says “Claim submitted” without a name. MedMe could not confirm who took the action, so it shows the time only rather than guessing.
Conclusion
The Claim Details modal gives a complete read-only picture of a claim: the summary band for status and totals, Overview for the payer response and per-line payments, Details for exactly what was submitted, Remittances for the payer’s payments and adjustments, and Activity for the claim’s full history of submissions, responses, and payments.
See more:
Have Questions?
Email care@medmehealth.com or message us via live chat for further assistance.