Billing
Rejections
Work the claims the clearinghouse or a payer turned away, fix them and send them again.
A rejected claim never reached adjudication: the clearinghouse refused the file, or the payer turned the claim away in its acknowledgment. Rejections are different from denials. A denial arrives with the payer's remittance after the claim was processed.
Open Rejections in the Billing panel of the main menu. You need the permission to work rejections.
Rejected claims#
The Rejections page lists every claim in Clearinghouse rejected or Payer rejected, the oldest first. Each row shows:
- who rejected it: the clearinghouse, the file format check (999) or the payer (277CA);
- the error code and description, and where it points (a loop, segment or field) when the sender says so;
- a short hint on what to check, such as the member id on the coverage or the provider NPI;
- how many more errors the claim has.
Click Filter to narrow the list by payer or status, to work one payer at a time.
Fix and resubmit#
- Choose Fix and Resubmit on the row (or in the claim's header) and confirm.
- NeatPractice copies the claim to a new Draft with a new claim number and the same charges, and closes the rejected claim. Its errors are marked resolved.
- Fix the cause. Most fixes are in the patient's coverage, the provider or the practice settings; the draft picks them up when it is sent. Box 19, notes and lines can be edited on the draft itself.
- Choose Submit on the draft.
Unmatched messages#
Open Unmatched messages in the Billing panel to see the messages from the clearinghouse that named no claim of your clinic, for example an acknowledgment for a claim number NeatPractice does not know. They show the kind of message, when it arrived and a short note. Choose Dismiss once you have looked into one; the message stays on record. Dismissed by mistake? Choose Undo in the confirmation that appears, or open Show Dismissed and choose Restore on the message to put it back in the queue.
If your clearinghouse delivers acknowledgments to a mailbox, Check Mailbox on the Rejections and Unmatched messages pages collects the waiting ones now instead of at the next half hour.