Creating and Filtering Denial Instructions
In this article, you will learn how to build instructions to assist the Denial staff. Creating instructions in Rivet keeps all Standards of operating-SOPs (How-tos) in one area to help guide the end user to complete the appeal process. The Denial settings page provides tools for creating and managing denial instructions. You’ll learn how to:
1. Navigate to the Denials Settings
Click on the account name on the top right and and click on Account settings.
Click on Denials in the bottom left. This will open the Denial settings page.
2. Navigate to the instruction page
On the Denial settings page, click on the Instructions tab and then click on the Create instruction button.
3. Create an instruction
On the Denial settings page, click on the Instructions tab and then click on the Create instruction button.
4. Select the applicable payer
Select the payer this instruction belongs to from the Payer dropdown.
5. Add rules and guidance
Add rules for your instruction and clear any rules that aren’t applicable.
Outline instructions for your team with guidance for resolving the denial
6. Attach policies or forms as needed
Attach a policy, contact, or form by clicking the Attach policy, Attach contact, or Attach form dropdowns.
Click on Create instruction to complete.
7. Search for instructions
Use the Search field to find specific instructions by searching for keywords or criteria.
By payer name
By adjustment code
8. Using filters to narrow your search
Alternatively, you can use the filters on the left to narrow your instruction results by specific rule criteria.
9. Deleting instructions
Click on the Options menu (ellipses) for the instruction.
Click on Delete.
When deleting an instruction Rivet will ask you if you are sure you want to delete and give you information on how many denials are affected by this change. Confirm by clicking the Delete instruction button.
10. Editing instructions
Click on the Options menu.
Click on Edit.
The instructions modal will open with your specific instruction. From here you can edit Notes, Rules, Policies, and Contacts. Click the Apply changes button to save your edits.
If you have any additional questions about the Claim Resolution feel free to chat in or email at support@rivethealth.com
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