Overview
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Sample Reports
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Portal
Back Office
Field Definitions
Field | Description |
|---|---|
| Code | The name, or up to 10 character code, of the adjustment and denial rule. System adjustment and denial rules have a prefix of RC. |
| Level | The categorization of the denial code. Options include: System, Practice, Payer, Plan. |
| Description | The description of the adjustment and denial rule. |
| Active | The current status of the adjustment and denial rule. Options include: All, Active, Inactive. |
| Group Code | The name of the denial code grouping assigned to the adjustment and denial rule. |
| Roll To (Primary) | The adjustment and denial rule for rolling primary financial responsibility to the next party. Options include: Do Nothing, Next Plan, Guarantor, Write Off Balance. |
| Adjustment (Primary) | Specifies if a primary adjustment is allowed. Options include: Allowed, Disallowed. |
| Writeoff (Primary) | Specifies if a primary contractual writeoff is allowed for the adjustment and denial rule. Options include: Allowed, Disallowed. |
| Roll To (Non-Primary) | The adjustment and denial rule for rolling non-primary financial responsibility to the next party. Options include: Do Nothing, Next Plan, Guarantor, Write Off Balance. |
| Adjustment (Non-Primary) | Specifies if a non-primary adjustment is allowed. Options include: Allowed, Disallowed. |
| Writeoff (Non-Primary) | Specifies if a non-primary contractual writeoff is allowed for the adjustment and denial rule. Options include: Allowed, Disallowed. |
| Practice | The practice for which the denial code is associated. |
| Payer | The payer to which the denial code is associated. |
| Plan | The plan to which the denial code is associated. |
| Excluded from Denial Code Reports | The designation as to whether the denial code is included in Denial Code reports. Options include: Yes, No. |
Available Report Filters
Option | Type | Required | Description | ||
|---|---|---|---|---|---|
| Code | Drop Down | No | Filters by code. Note: System codes begin with a prefix of 'RC'. | ||
| Level | List Selection | No | Filters by the categorization of the denial code. By default, this filter is set to All. Options include:
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| Active | Drop Down | No | Filters by the current status of the adjustment and denial rules. Options include: Active, Inactive. By default, this filter is set to All. | ||
| Denial Code Group | List Selection | No | Filters the list of denial codes by group assignment. By default, this filter is set to All. | ||
| Practices | List Selection | No | Filters by all practices or by one or more practices. By default, this filter is set to All.
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| Payers | List Selection | No | Filters by payer to which the claims were submitted. By default, this filter is set to All. | ||
| Plans | List Selection | No | Filters by plan to which claims were submitted. By default, this filter is set to All. | ||
| Report Folder | Drop Down | Yes | Designates where to place or save the output from the executed report. |