Why Was My Claim Denied?

 

   Sometimes a claim will be returned by DrChrono's system, the clearinghouse or the payer.  The reasons could vary from missing information, the time limit for submission has expired or the patient's diagnosis is unexpected with the patient's sex.    You will be able to see the entire denial verbiage so you will know what to caused it to deny and thus, what you need to update before resubmitting. 

 

You can find these claims under Billing > Live Claims Feed > Claim St.

 

Screen_Shot_2020-10-16_at_11.29.27_AM.png

Screen_Shot_2020-10-16_at_11.28.10_AM.png

 

 By selecting a date range and using the Calculate Counts function, you will be able to see the number of claims in each of the denial statuses, Rejected, ERA Denied and Missing Information at a glance.

 

 

In order to see the exact reason the claim denied or rejected, please follow the steps outlined below:

 

1. Click on the Claim St dropdown.  By default, all of the statuses will be selected.

2.  Click on the check next to All Statuses to unselect them all so you can select the ones you want, or you can manually click next to the statues you do not want to see.

3.  Once chosen, click on Update Filter and the system will show you just the claims in the statuses you selected for the date range listed.

 

Screen_Shot_2020-10-16_at_11.53.51_AM.png

 

4.  Click on the date of service of the claim you would like to review.

 

Screen_Shot_2020-10-16_at_11.57.46_AM.png

 

5. Scroll down to the claim detail section and click on the words ERA Denied, Missing Information or Rejected.

The system will display the actual rejection received from the source (DrChrono, the Clearinghouse or the Payer).   Please review the denial and make any necessary corrections to the appointment.

 

 

If you need to resubmit the claim after reviewing the denial and updating the appointment/patient chart, you will need to check the box Resubmit claim and then click on Verify and save.  This will send the claim to the clearinghouse and hopefully onto the payer.

 

Screen_Shot_2020-10-16_at_12.02.18_PM.png

 

Best practice is to review for denials each day.  A claim that is sitting in one of these statuses is not being processed by a payer, which means that your reimbursement will be delayed.  We want to make sure you are promptly paid for the great services you provide to patients!

Was this article helpful?
0 out of 0 found this helpful
Have more questions? Submit a request

Comments

Powered by Zendesk