Denials
Denials is the work list for claims the payer denied on remittance—fully or only on some procedure lines. Update the reason, add comments, open the claim to fix coding, appeal with a letter and CMS-1500 (HCFA) package, then resubmit when ready.
Denials Management
Review, resubmit, and appeal ERA claim denials.
Total Denied (Unworked)
0
No new denials
Denial Value
$0.00
Action required
Resubmitted This Week
0
Pending response
Appealed This Week
0
In review
| Claim # | Patient | DOS | Payer | Billed Amount | Reason | Comments | Status | Actions |
|---|---|---|---|---|---|---|---|---|
| No denials found matching the current filters. | ||||||||
Full Denial vs Partial Denial
Full denial: the remittance was marked Denied (no paid lines after verify). Partial: some CPT lines were denied while the remittance overall may show verified—often labeled Denied (Partial).
Summary Cards
Watch Total Denied (Unworked), Denial Value, Resubmitted This Week, and Appealed This Week.
How to Work a Denial
Search by patient, claim number, or payer. Open the claim, correct diagnosis/procedure/providers/member data as needed, set resubmission details (including original payer claim number when required), and submit again. Update denial reason and comments so the team knows what was done.
Appeal Package and HCFA / CMS-1500
Appeals can include a generated letter, supporting PDFs, the CMS-1500 (HCFA) from the latest submit, and the ERA PDF. Deliver by fax or email when your practice supports it, or download the package. HCFA here is the printable claim image—not a separate Billing menu tab.
No Denials Found
No denied remittance rows match your filters, or denials have not been verified yet. Widen search or confirm remittance was verified as denied.