1. Claim History Overview
This article will outline the different screens that will assist you in resolving the denial. You will understand how the screens will help you know what transactions were taken on that claim. This article will cover:
View Claim
Chronological View
Itemized View
Action Column
2. View Claim
Click on the claim you would like to view on the worklist. There are two available views of a claim's history.
Once you are in the claim page, click on the Transaction history tab
3. Chronological View
The Chronological view shows the full claim's history by transaction date.
4. Itemized View
The Itemized view breaks out the history by each CPT code. You can also view the Transaction history.
5. Actions column
The Actions column will have automatic tags associated. Below is a description of the different tags you may see populate in the Actions column:
VOID:
Any time there's a take-back
Can occur in both claim and remit transactions
SPLIT:
Claims with exactly one claim transaction and one remit transaction, and a line item that has the
same total quantity on the claim and the remit, but appears more than once on the remit.
Would only appear on remit transactions
FORWARD:
Claims with a forwarding primary payer and a non-forwarding secondary payer
RECODE:
Claims with a line item that has a different billing code on remit vs. claim
Claims with a line item that has different modifiers on remit vs. claim
Would only appear on remit transactions
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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