Some claims on the Claims page show a "Why is this claim stuck?" flag next to their status. It means the claim isn't moving on its own right now — click the flag for a one-line explanation. This article covers each case: what happened, what Taiga is doing, and whether you need to do anything.

We're waiting on documentation or an answer from someone at your practice — commonly a chart clarification, a signature, or missing visit details. Look for a message from Taiga about the claim; responding is what unblocks it. These claims also show Needs your attention as their owner and appear on the Queues page.

Something required for a clean submission is missing. Taiga is tracking it down; if we need anything from your team, we'll reach out directly.

The claim was turned back before the payer adjudicated it — usually a data or formatting issue like a bad member ID or an enrollment edit. A rejection is not a denial: nothing has been refused, the claim just didn't get through the front door. Taiga corrects and resubmits these.

The payer adjudicated the claim and refused payment. Taiga's ops team works a denial resolution — appealing or rebilling as appropriate. You don't need to act unless we reach out for supporting documentation.

Payment arrived but doesn't match what's expected — underpaid against the contract, or misapplied. Taiga files an appeal or correction with the payer.

The payer's electronic remittance arrived and needs a human look before it posts — unusual adjustment codes, split payments, and the like. Taiga's ops team reconciles it; no action needed from you.

A claim sitting in Submitted or Awaiting payer isn't flagged — payers routinely take weeks to adjudicate, and that's normal in-flight time, not stuck. Claims with no payer response for an unusually long time get flagged internally as stale and receive proactive follow-up.

If a flagged claim worries you, open it and check the Activity timeline and Tasks — they show exactly what's happening — or email [email protected] with the claim ID.