Post and View Denied Claims

When paper denials are received from payers, you can manually post the denials to more effectively track and report denied claims. Tracking claim denials help determine internal patterns and trends, as well as those with specific payers, to quickly identify and remediate the common issues causing the denials.

Manually Post Denial Create a new insurance payment and enter the information as necessary under the General tab with the following. Method: Click the drop-down arrow and select 1 - Check as the method since this is a zero dollar amount payment. Amount: Leave as $0.00. Once finished, click Apply Now. The Apply tab opens.
Use the top options to add the encounter or patient as necessary. The first drop-down menu defaults to Add Encounter. To add service lines by patient instead, click the drop-down arrow and select Add Patient. Note: When encounter is added, all service lines associated with the encounter are listed. When a patient is added, all open service lines associated with the patient are listed. In the field, enter the encounter ID or patient's name. Then, press Enter on the keyboard. The service lines are listed. Note: The encounter ID may be indicated as the Patient Account Number or Claim Reference ID on the payer report as follows Encounter ID + Z + Kareo ID (e.g., 176Z15050).  Tip: Enter the encounter ID + Z (e.g., 176Z) to quickly add the appropriate record and avoid having to search and select it. If the Select Encounter or Find Patient window opens, search and select the appropriate record. Show Only: Defaults to Selected. Click the drop-down arrow to select to list All, Open, Settled, or Negative Balances service lines. Click to select the patient, encounter, and/or service line for the denial. Under the Simple (EOB) tab, leave all amount fields as $0.00 and ensure the Status is set to Default.
Select the Advanced (ERA) tab. The Advanced (ERA) information displays. Click More +. Additional options display.
Click the drop-down arrow and select Reason. Once selected, additional fields become available. In the field, enter the denied amount. Click the first drop-down arrow and select the reported denial reason code. Click the second drop-down arrow and select the reported claim adjustment group code. Click Post. The Reason line for the denial is added.  Note: This will display when viewing the Denial transaction line information on the Claim record. When done with the selected service line, do one of the following. To continue, click Next Line if the denial applies to the next service line listed, or click to select the appropriate service line. Then, repeat steps 5-10 as necessary. To return to the top options and add another encounter or patient, click Add Encounter or Add Patient. Then, repeat steps 3-10 as necessary. If finished, click Save. If a confirmation pop-up appears, click Yes to post the payment with a $0.00 amount.
Find and View Denied Claim Click Encounters > Track Claim Status. The Find Claim window opens. Click the drop-down arrow and select Denials. If necessary, use the Search box to enter all or part of a keyword for the claim. Then, click Find Now.  Find the denied claim and double click to open. The Edit Claim window opens.
Under the Transactions section, scroll if necessary to find the Denial transaction line then hover over the line to display the denial information.  Tip: Right click on a transaction line and select View Details to view any additional details related to the transaction if applicable.