{% for claim in claims %} {{ claim.claim_number }} {% if claim.prior_auth_number %}
Auth: {{ claim.prior_auth_number }} {% endif %} {{ claim.medical_bill.bill_number }}
{{ claim.medical_bill.patient.get_full_name }}
MRN: {{ claim.medical_bill.patient.mrn }}
{{ claim.get_claim_type_display }}
{{ claim.insurance_info.insurance_company }}
{{ claim.insurance_info.policy_number }}
{{ claim.submission_date|date:"M d, Y" }} ${{ claim.billed_amount|floatformat:2 }} ${{ claim.paid_amount|floatformat:2 }} {% if claim.allowed_amount %}
Allowed: ${{ claim.allowed_amount|floatformat:2 }} {% endif %} ${{ claim.patient_responsibility|floatformat:2 }} {% if claim.deductible_amount %}
Deductible: ${{ claim.deductible_amount|floatformat:2 }} {% endif %} {% if claim.status == 'DRAFT' %} Draft {% elif claim.status == 'SUBMITTED' %} Submitted {% elif claim.status == 'PENDING' %} Pending {% elif claim.status == 'PROCESSING' %} Processing {% elif claim.status == 'PAID' %} Paid {% elif claim.status == 'DENIED' %} Denied {% elif claim.status == 'REJECTED' %} Rejected {% elif claim.status == 'APPEALED' %} Appealed {% elif claim.status == 'VOIDED' %} Voided {% endif %} {% if claim.denial_reason %}
{{ claim.denial_reason|truncatechars:30 }} {% endif %} {{ claim.days_pending }} days {% if claim.response_date %}
Response: {{ claim.response_date|date:"M d" }} {% endif %} {% empty %}

No insurance claims found.

{% endfor %}