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My Claim Was Rejected by the Payor. How Do I Fix The Problem And Resubmit It?

Updated over a year ago

Video How-To

Step-by-Step

Finding Rejected Claims

If your claim is rejected by the payor, its status will be updated to Rejected on the Kinetik platform. You can easily view your rejected claims by navigating to the Billing Dashboard, and clicking on the Rejected button at the bottom of the page.

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Locating the Problem

Select the rejected claim you’d like to view, and fix for resubmission.

Scroll to the bottom of the individual claim view, where you can view the services billed and the amount paid. Since the claim was rejected, the amount paid will be $0.00, but the Adjustment Reason area can offer information as to why it was rejected. Click on the Adjustment Reason code to view a pop up with those details.

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Solving the Problem

The Adjustment Reason Detail pop up box tells you why the claim was rejected. If it was because of an incorrect detail—such as incorrect patient details, or a coverage problem— you can edit the claim and resubmit it.

Edit the Claim

Navigate to the area with the problem. If the problem is with patient details, click edit in the upper corner of the patient box, make your changes and click Update. If the problem is with another area of the claim, the process is the same.

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Resubmit the Claim

Once you’ve made the necessary changes, you can resubmit the claim. Begin by setting the claim as Ready to Bill. Click on the Rejected status button in the upper right corner, then pick Ready to Bill.

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Once the claim has been set as Ready to Bill, you can submit the claim by clicking on the Select Action menu in the upper right, and picking Submit Claim. Confirm the amount and click Submit Claims to finish the process.

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Still need help? Send us an email at support@kinetik.care, start a live chat on the platform, or call us at 631-593-2594 ext. 1. We're available from 9a-6p Eastern Standard Time.

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