When a provider sends an e-bill, if the e-bill contains Patient or Injury Information that does not match the claims administrator’s patient or injury information, the claims administrator’s clearinghouse rejects the e-bill.
This e-bill rejection alerts you that the clearinghouse did not forward the rejected e-bill to the claims administrator for payment.
daisyBill creates a Clearinghouse Rejected Bill Task to alert your account and allows you to correct erroneous patient or injury information.
For more information on the Rejected Bill Status, see the Help Article: Rejected.
Step 1. Click ‘Verify Patient/Injury’
Step 2. Review the 277 Reject Acknowledgement
daisyBill displays the 277 Reject Acknowledgement that the clearinghouse sent, explaining why it rejected the e-bill.
Step 3. Call the Claims Administrator to obtain the correct patient and injury information.
daisyBill lists the relevant Claims Administrator phone numbers for you!
Step 4. Verify Patient / Injury Information with Claims Administrator representative.
daisyBill provides a list of all Patient and Injury information you need to verify while speaking with the claims administrator.
Step 4a. If the representative confirms the submitted information is correct, click the "Yes" button.
If the claims administrator verifies that all of the Patient and Injury information sent in the e-bill is correct, this means the clearinghouse erroneously rejected the e-bill.
If the claims administrator verifies that all of the Patient and Injury information sent in the e-bill is correct, enter the contact information for the claims administrator representative who verified the patient/injury details.
For erroneously rejected e-bills, daisyBill flags the e-bill with a ‘daisyBill Researching’ alert and contacts the clearinghouse to investigate the reason for the rejection error.
Once the clearinghouse confirms it has resolved the rejection error, daisyBill automatically resubmits the e-bill on your behalf, at no extra cost.
Step 4b. If the Claims Administrator reports that any of the Patient or Injury Information is incorrect, click the "No" button(s)
Enter the correct information provided by the representative in the appropriate field(s).
The contact information for the claims administrator representative who verified the patient/injury details is optional.
Step 5. Click ‘Save’
Clicking ‘Save’ navigates you back to the bill, which shows the corrected Patient or Injury information.
Step 6: Click ‘Send Bill’
To resolve the Rejected Bill task and receive payment, simply click the Send Bill button.