Rejected Claims
complete
B
BRIAN STONE
It would be helpful to receive notice whenever a claim is rejected so that it could be acted on immediately. At present, you only become aware of a rejected claim if you are actively / manually checking claims status. Perhaps this feature could be added to "Settings" - "Claim Notifications"
Tyson Edwards
Ok, this should be released today so keep an eye out for anything that looks off. We added:
- Validation to DX codes
- Rejection Notifications
- If entire batch is rejected, the rejected claim goes back into draft and the rest go to validated status.
A
Ann Marie Linden
This is NOT complete. I do NOT get a notification. I only find out if I search claims and a "rejected" label.
T
Tina Koro (IntakeQ)
complete
Released for Office Ally customers. Email notifications for rejected claims.
Northstar Counseling Center
Tina Koro (IntakeQ) does this mean that each individual clinician attached to the claim through intakeq will receive a direct email about a claim rejection?
Tyson Edwards
Ok, this should be released today so keep an eye out for anything that looks off. We added:
- Validation to DX codes
- Rejection Notifications
- If entire batch is rejected, the rejected claim goes back into draft and the rest go to validated status.
J
Jessica Sparrow
Tyson Edwards still not following how we will be notified of the rejected claim? or what the update to functionality is... could you please clarify :)
Tyson Edwards
Jessica Sparrow
We added validation to Diagnosis so it can't be free text or anything other than a Dx code
If a claim gets rejected by the clearinghouse, you'll get an email with the claim number, error, segments and other claims that were a part of the batch that was rejected. Example below.
If the batch is rejected, the rejected claim gets put in DRAFT and the rest get put in VALIDATED state so it's easy to resubmit.
J
Jennifer Hill
Tyson Edwards Is there a way for this notification to occur if a claim is rejected/denied by the insurance company (not just the clearinghouse)? I would love a notification for that as well, rather than needing to manually check claim statuses.
J
Jessica Sparrow
Tyson Edwards thank you for your response! very helpful!! to receive the email... do we have to opt-in somewhere to do this? or will it just automatically be a standard feature?
Tyson Edwards
Jessica Sparrow: It's standard but I should mention this is only for Office Ally clearinghouse submitters.
J
Jessica Sparrow
Tyson Edwards I am with office ally and I dont receive an email notifying me of claims that are rejected. How do I set that up?
Tyson Edwards
Jessica SparrowYou should start. It was just released today.
Tyson Edwards
Merged in a post:
Notification of Denied Claims
B
BRIAN STONE
It is extremely important for clinicians to know when there are exceptions to claims processing (rejection, denial, etc). At present, there is no "alarm" so to speak to tell me that a claim has been denied (a flag, notification, invoice, email, etc). The only way to know that a claim is denied is to run the filter to search for denied claims but this requires clinicians to run that filter on a regular basis to ensure that denied claims are not missed. This is not very efficient. To me, the easiest solutions would be to either (1) implement an email notification when claims are denied the same way that you did when they are rejected by the clearinghouse or (2) automatically create an invoice given the amount is kicked back to the patient just like you do when they owe a copay or deductible.
Tyson Edwards
in progress
There was a misunderstanding in the functionality here. We do have a solution for this in progress currently. This will send a notification when the claim is rejected and flip the status back to draft. If it's a bulk submit then the rest of the claims will go back to validated. Should be out soon!
A
Annie Frisbie
Tyson Edwards can you clarify please? All the other claims will go back to validated if one is rejected? Even if they've been acknowledged by the clearinghouse?
Tyson Edwards
Annie FrisbieThis is for Office Ally specifically but we've seen a single claim get rejected in a batch and it rejects the entire batch. Is this what happens in your experience? We are also adding some validation on Dx codes so claims are less likely to get rejected due to Dx incorrectly entered.
A
Annie Frisbie
Tyson Edwards thankfuly that doesn't happen to me. Dx code validation will prevent a lot of my rejections from happening
Tyson Edwards
Brian, we did this right?
B
BRIAN STONE
Tyson Edwards: Yes and no. We get a notification if it is denied/kicked back by the clearinghouse but not if it is denied by the insurance company after processing. I still have to manually check for insurance denials as there is no notification from IQ.
A
Annie Frisbie
BRIAN STONE this would be helpful too
Tyson Edwards
complete
Hello, we added a notification for when a claim comes back as rejected from the clearinghouse. It's tied into the ERA notifications so there is not an extra setting. Let me know if you get one!
Tyson Edwards
planned
Tyson Edwards
under review
T
Tyson Edwards
Great suggestion Brian! We are looking to provide a way to give more insight into these types of claims that need follow up. I have a request as well to display a the denied reason code. Would this be helpful?
B
BRIAN STONE
Tyson Edwards: Yes, that would be very helpful as well
Load More
→