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There needs to be a separate denial for EDI claims that have been denied by the payor when being processed by an ERA. Right now when EDI claims are rejected/returned by the clearinghouse or payor after submission, they are transferred to Filed Rejected. When a claim is being denied by the payor upon posting an ERA, the claim is transferred to the same “Filed Rejected.” Can there be a different denial status for this? Claims where there is a “EOB denial” could be transferred to a status of “denied- rejected” and EDI claims that are being returned by the clearinghouse or payor without a “EOB” be transferred to “filed rejected” This is causing a lot of confusion and causes more time cleaning up claims.
Posted : March 14, 2014 5:45 am
This is absolutely a great enhancement request. We would love to see this as well.
Posted : October 13, 2014 11:27 am
