Working rejected claims is the most important part of revenue cycle management. Premier provides multiple tools to help you manage and work rejected claims.
There are two types of rejected claims:
•Front End Rejections (rejection information found on clearinghouse or payer status reports)
o Clearinghouse rejections due to missing or invalid data.
o Payer rejections due to patient not found or some other issue that caused the claim to be rejected at the ‘front door’.
•Payer Rejections (rejection information found on the EOB or 835)
o Claim was processed by the payer but not paid due to reasons provided by reason codes and/or remark codes.
Premier handles both types of rejections and provides tools to create tasks or work lists to manage follow up and make sure these claims are taken care of.