Claims which have line sub status as ‘DENIED’ or a denial category code set while posting the claim are considered denied. Such claims are placed in collection manager in order to rectify them and rebill them to the payer.
Select Collection manager from the main menu to open Collection Manager screen as in Image 1.
Select Denials radio button to display all the denied claims.
Click on the search button and the screen displays all the denials grouped by the denial categories. Clicking on any category displays all the claims of the category in the lower part of the collection manager screen (refer to Image 2). the billed amount of a category is the sum total of billed amounts of the individual claims as highlighted in Image 2.
Click on any claim to follow-up. This opens the Denials Workshop with the claim details populated, see Image 3.
Follow-up
Further action on the denied claims is done from this section. The fields/actions of this section are explained in Table 1.
| Field | Description |
| Follow-up Notes | Provide notes (if any) |
| Remind me in | Specify the days for which the claim is to remain invisible in the collection manager. (for instance, when you are waiting for a response from the payer, and can work on the claim only after that.). To display the invisible claims, check the checkbox ‘Show Reminders’ in the search section. |
| Date | The date until which the claim is to remain invisible. |
| Create Action item for | Select the user to whom the claim has to be assigned to. |
| Action Note | Any notes pertaining to the action to be sent to the assignee. |
| Status | All denials are first in the NEW status. Change the status to PENDING to work on the claim. Change to RESOLVED when the claim is rectified. |
| Sub Status | Set an appropriate sub status |
| Apply To All Claims in this Category | If all the above actions are to be applied to all other claims in the same category, check this checkbox |
| Push to “Need more info queue” | To move the claim to the work queue, check this checkbox |
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After taking necessary actions on the claim, it can be rebilled and batched from this screen as well. |
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This action rebills the claim |
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Saves the follow-up actions taken. |
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Closes the screen to go back to Collection Manager |
All follow-up actions taken will be available in the Follow-up Hx tab next time the workshop is opened.