Work Denied Claims

Denied claims are worked on the Claims Workbench tab under Financials > Claims Management.

To work a claim:

  1. Move claims to the workbench by selecting their checkboxes and then clicking the Move Claims to Workbench button.

  2. Click on the Claims Workbench tab.

  3. Select the Service Line, and if applicable, select a Client. Click the Search button.

  4. Expand the claim by clicking the + (shown here as a -) to view the Denial Code, then click the Ellipsis in the Actions column to select what you need to modify.

    Expanded Claim

    If you want more information displayed, click the Columns icon and select what information you would like to display.

    Claims Workbench Columns Button

  5. After corrections are made, select the radio button next to the claim. Then, based on the denial code, click the applicable resolution button.

    The record goes through the system validations and comes under the Ready card to be sent to the payor again.