Denial Work Queue
Every denied or rejected claim, opened as a piece of work by the overnight job, with what kind of denial it is and what usually fixes it. Resubmitting sends the corrected claim -- as a replacement when the payer had already adjudicated it.
Where to find it
- Module: EHR
- Group: Revenue Cycle
- Section: Revenue Cycle
- Screen: Denial Work Queue
Address in the console: /ehr/denial-work-items
List · 10 columns · 6 fields on its form · 1 action
What the list shows
These are the columns of the list, in the order they are drawn. Any of them can be sorted on, filtered on, hidden, or exported.
| Column | Kind | Field name |
|---|---|---|
| Item | Code | item_no |
| Claim | Code | claim_no |
| Patient | Text | patient_name |
| Payer | Text | payer_name |
| Kind | Status | category |
| Code | Code | denial_code |
| At risk | Amount | amount_at_risk |
| Due | Date | due_date |
| With | Text | assigned_to_name |
| Status | Status | status |
The form
What is asked for when a record is created here. Required fields are marked; a choice drawn from a configuration list is one an administrator can extend without a release.
| Field | Type | Choices | Notes |
|---|---|---|---|
| Due | Date | ||
| Kind of denial | Choice | eligibility, authorization, coding, duplicate, timely_filing, missing_information, medical_necessity, coordination_of_benefits, other | |
| What should fix it | Long text | ||
| Status | Choice | open, working, resubmitted, appealed, written_off, closed | |
| What was done | Long text | ||
| Notes | Long text |
What you can do here
Resubmit primary
Resubmit the corrected claim
Asks for: What was corrected
The rules that apply here
Everything on this screen obeys the platform rules rather than rules of its own. The ones worth knowing before you use it:
- Narrowing a list — search, conditions, sort, totals, export and saved views.
- What may be changed — the five grounds a record may not be edited on.
- Companies and business units — what the switcher above this list is doing to it.
- Creating a record — required fields, where choices come from, and how the number is allocated.
- Importing a spreadsheet — this screen accepts one, and it runs through the same rules as typing.