FAQs‎ > ‎General FAQs‎ > ‎

How do I follow-up on my denied claims?

posted Aug 11, 2018, 6:57 PM by Samantha Turner   [ updated Aug 11, 2018, 6:57 PM ]
When you're ready to follow-up on denied claims, there are a couple locations in the CollaborateMD application that will help you locate and manage the claims. 

1.  In the Control section, you can use the Claim Tracking tab to follow-up on front and back-end edits. Use the filters on the left-hand panel of the screen to control this setting. 
  • Front-End Edits: Edits received via Clearinghouse Reports. Whether they are Exclusions received by the Clearinghouse or rejections received by the Payer under the Payer Generated tab.
    • Claims impacted by Front-End Edits may be corrected and resubmitted using CollaborateMD. 
Back-End Edits
    • Claims impacted by Back-End Edits must be discussed directly with the payer who denied the claim. Once the denial is addressed, the claim may be corrected and resubmitted. Visit the following Help Page to find tips related to Resubmitting Claims. 
Important: It is highly recommended marking claims as "Error Fixed" via the Control section to keep track of claims that were corrected. This will help you filter by claims that have been corrected or claims that haven't.

2. In the Reports section, you have two options:
  • Denials Report: The denials report only focuses on Back-End Edits. This report is really good because it focuses on details such as the denial reason and the patient. 
  • Clearinghouse Reports: These reports contain edits received by the Clearinghouse or Payer Electronically. These are the same edits that appear within Claim Tracking, Front-End Edits. 
Note: Please be aware that not all payers participate in submitting Clearinghouse Report. Some Payer Generated Reports found in Reports - Clearinghouse Reports are NOT always viewable in Claim Tracking. 

Review the following Help Page to learn more about the benefits related to Clearinghouse Reports: