Path: Navigation Form > 835 Form > Working Queue tab

Path: File > Billing > Line Items

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When importing an 835 file in the HIPAA 835 Inbound Form, by default, the Do Not Post Denied checkbox is selected. When clicking the Post button, the system will post the remittance lines in Records To Post to their matching Line Items. At the same time, the Post column checkboxes for lines that are denied become unchecked, and those lines can be moved to the Working Queue along with the records listed under Records Unable To Post. Follow the steps below to work on your claims that were denied.

Denial Workflow

1. Navigate to the Line Items Filters Form by using the path above.
2. In the Denied (Y/N) field, type Y.

1. Click the Ok button. The Lines Item List is displayed.
2. Click on the Line Item you want to work on and click the Ok button to open the Line Item Form. As shown in the screenshot below, the Denied checkbox is selected and the Denied Date, Denial Reason Code, and Description are displayed. 

1. Click the Edit button to re-work the claim and prepare it for resubmission, according to the reason for the denial.
2. Once you've made your changes, deselect the Denied checkbox.
3. Change the Print Status to a Y so that it will be picked up in a batch of claims to be sent out.
4. If you are sending a replacement to the same payer, select a Claim Frequency Code to reflect the reason for resubmission. If the Original Reference Number did not auto-fill, fill that in from the ERA or EOB.
5. Click the Save button.

1. Lastly, if this denial was from an ERA, to remove it from the Working Queue list, select the Delete checkbox from the Working Queue window and click the Delete Selected button.