All ERAs undergo scanning for denials and are automatically flagged as "left open" for convenient identification. During this process, the adjustment amount linked to a denial is removed, while the remaining insurance balance remains unaffected. Any items designated as "left open" are subsequently transferred to the denial queue, enabling your team to address and revise these claims to ensure maximum reimbursement. 

Denied Claims

When the denied claim comes into RXNT system, the Leave Open checkbox is automatically selected, and the claim is placed in the Denial/Left Open Tab.

Once the denied claims are placed in the Denied/Left Open tab, you can utilize the Columns icon to navigate through the different columns within the tab.

Appeal Letter

If you want to send an appeal letter to the payer, click the Printer button in the Appeal Template column. The system will then prompt you to select one of your pre-made templates. Once you’ve chosen the template you wish to use, click on the Generate button to Print or Edit Content and Re-Generate.

Additional Information

Turn off denial management

By default, the Denial Management workflow will be turned ON for all companies. To turn it OFF, click Utilities.

Click Preferences

Select No for Enable Denial Management.

Click Save and log out and into the system to apply the preference.

Once the denial management is turned off, the leave open box will not be checked automatically for any ERA payments and the adjustment amount associated with the denial code will be automatically populated in the insurance payment. To learn more about Denial Management, click here.  

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