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Kareo Help Center

Post and View Denied Claims

Updated: 05/06/2022
Views: 10337

When payers deny claims, you can post the denials to more effectively track and report claim denials. 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

  1. 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.
  2. Once finished, click Apply Now. The Apply tab opens.
Desktop_InsDenial_NewPmt.png
  1. 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.
    • In the field, enter the encounter ID, patient's name or ID. Then, press Enter on the keyboard. 
      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_Icon.png 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.
      • If an encounter is added, all service lines associated with the encounter are listed.
      • If a patient is added, all open service lines associated with the patient are listed.
    • Show Only: Defaults to Selected. Click the drop-down arrow to select to list AllOpenSettled, or Negative Balances service lines.
  2. Click to select the patient and/or service line for the denial.
  3. Under the Simple (EOB) tab, leave all amount fields as $0.00 and ensure the Status is set to Default
  4. Click More + in the lower right of the window. Additional options display.
Desktop_InsDenial_ApplyTab_More+.png
  1. Click the drop-down arrow and select 7 - Note. Once selected, an additional field becomes available. Then, enter the reported remarks to describe the reason(s) for the denial.
  2. Click Post. The Note transaction line for the denial is added.
  3. Once finished 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 5-9 as necessary.
    • To return to the top options and add another encounter or patient, click Add Encounter or Add Patient. Then, repeat steps 3-9 as necessary.
    • If finished, click Save. A confirmation pop-up appears. Click Yes to post the payment with a $0.00 amount.
Desktop_InsDenial_Note_Post.png

Find and View Denied Claim

  1. Click Encounters > Track Claim Status. The Find Claim window opens.
  2. 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
  3. Find the denied claim and double click to open. The Edit Claim window opens.
Desktop_InsDenial_FindClaim.png
  1. Under the Transactions section, scroll if necessary to find the Denial transaction line to review the details.
    Tip_Icon.png Tip: Right click on a transaction line and select View Details to view any additional details related to the transaction if applicable.
    • For a manually posted denial, review the Note transaction line.
    • For an automatically posted denial from an ERA, hover over the Denial transaction line and the details display (as shown in the image example). 
Desktop_InsDenial_EditClaimTrans.png
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