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Workflow Services Product Update and Newsletter Vol. 19 - September, 2026

Select the Right Vaccine Product Every Time

As vaccine products and coding can change from season to season, it’s important to make sure the correct vaccine product is selected during the administration workflow. The product selected can impact the coding and reimbursement associated with the claim, so taking a few seconds to confirm the right product can help prevent billing issues.

Quick check: Before administering vaccines, compare the vaccines you plan to administer with the vaccines that are currently active in your WFS workflow. If anything needs to be added or updated, you can make those changes from the Pricing page of the Web Portal.

Remember: For a vaccine to be active in the workflow, the Price field must contain a value — even if that value is $0.00.

The good news is that WFS keeps an eye on vaccine coding changes and updates from season to season, so you don't have to. That's one of the advantages of working with WFS. We take care of the behind-the-scenes coding updates; you just need to select the correct product when administering the vaccine.

Think of it much like selecting a vaccine product in your PMS: the right product needs to be selected at the time of administration.

We submitted a claim, but did we get paid?

Medical claims can take longer to adjudicate than pharmacy claims, so remembering to check on them can be difficult. That’s why following claims from submission through final resolution is part of what Workflow Services does for you.

Our bespoke workflows are built with medical coding specific to the services being submitted, helping eliminate the need for trial and error on your end. Even with the right coding, however, some claims are denied or require additional information from the pharmacy. Other claims may be paid by the payer but include patient responsibility, such as a copay or coinsurance.

That’s why it’s important to use the Claims page in the Workflow Services Web Portal to check not only which claims have been paid, but also which claims need your attention.

Know Your Claim Status

Returned
The claim was submitted to the payer, and WFS received the Electronic Remittance Advice (ERA) indicating that additional information is needed from the pharmacy. This could include updated patient demographics, additional diagnosis information, or different payer information. Returned claims require action from the pharmacy before they can be resubmitted for payment. See this article for more information on how to edit claims and encounters. 

In Collection
The payer has processed the claim and paid its portion, but the ERA indicates that the pharmacy is responsible for collecting a remaining amount from the patient, such as a copay or coinsurance. Claims can remain in In Collection status for up to 90 days. If the amount cannot be collected during that time, the claim will automatically move to Completed.

Completed
The claim is done and requires no further action. This includes claims that have been paid in full by the payer, claims where patient responsibility has been collected, and claims where patient responsibility has been deemed uncollectable.

Completed claims are also the primary claims used when calculating certain metrics displayed in the Web Portal. For example, the "Insurance claims paid in the last 7 days" total on the dashboard is based on claims in Completed status. Payments are not reflected on the dashboard until the entire claim has been completed. If payment has been received from the payer but there is still an outstanding patient responsibility, that claim will not be reflected in the total shown on the dashboard until the patient responsibility has been collected or marked uncollectable. 

Make Checking Claims Part of Your Routine

We recommend assigning a task to check the Claims page at least once a week. Timely filing requirements apply to medical insurance claims, and letting a claim sit without the necessary follow-up can ultimately result in lost revenue.

WFS handles the claim journey, but we need your help when a claim requires pharmacy action. A quick weekly check of the Claims page can help make sure nothing requiring your attention gets missed.

✨ Thank you for continuing to partner with Workflow Services. Together, we’re shaping the future of pharmacy care!

Need Help?
If you have questions or need assistance with any new or existing features, don’t hesitate to reach out to support@imagemovermd.com.