Mapping Insurance Rejection Reasons

You can create and activate insurance rejection reasons. If an insurance carrier rejects a claim, the carrier includes a reason that explains why the claim was rejected so that you can correct the issue and rebill the claim. All claims and accompanying rejection reasons are displayed in AcuityLogic Billing.

Since different insurance carriers have different rejection reasons and may add new rejection reasons, you can use the Insurance Rejection Reason Mapping module in AcuityLogic Admin to decide which rejection reasons are included for each insurance carrier. You can also add a rejection reason to AcuityLogic Admin if a carrier adds a new rejection reason.

You cannot delete or edit a rejection reason after you create it. You must activate (include) a rejection reason so that it is displayed in AcuityLogic Billing.

For multitenant environments, the following setup can be performed only by administrators of the parent company and is required only for the parent company. The parent company setup applies to all companies.

To create and activate a rejection reason

  1. In AcuityLogic Admin, click Insurance and select Insurance Rejection Reason Mapping.

    The Insurance Carrier Rejection Mapping window opens.

  2. Click the Map Codes link next to the insurance carrier to which you want to add a rejection reason.

    The Mapping Codes window opens.

  3. Click Add Reason.

    The Add Rejection Reason fields display.

  4. Type a description of the rejection reason in the Description field.
  5. Select Yes from the IsDefault drop-down list if the reason is the default reason; otherwise select No.
  6. Select an action from the Action ID drop-down list to indicate what you should do when the carrier assigns this rejection reason to a claim.
  7. Select Yes from the Is OverPaid Reason drop-down list if the reason indicates that the claim has been overpaid; otherwise select No.
  8. Select Yes from the Is UnderPaid Reason drop-down list if the reason indicates that the claim has been underpaid; otherwise select No.
  9. Click Save to save the reason.
  10. Select the Include check box next to the rejection reason you want to activate.

    OR

    To activate all of the rejection reasons that display on the page, select the Include check box in the column heading.

  11. Click Save to save your changes and close the window.

Related Topics