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Joy Hicks

This Week's Q & A

By March 28, 2011

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Q&A

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Question:What is a rejected claim?

Answer: A rejected claim is an electronically submitted claim that is unprocessable due to missing or invalid information required by the payer. The claim is "returned" or not be accepted electronically in the claims processing system.

Each claim submitted electronically has to pass the payer's editing process which screens certain items on the claim that are required for proper adjudication. The rejected claim will aware the provider of the missing or invalid information necessary for processing and can be resubmitted as a new claim.

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