The Claim Rejections report helps you identify patterns in claim rejections so you can spot trends, uncover recurring issues, and determine where adjustments to your billing workflow may be needed. This article explains how to access and use the report to better understand rejection trends across your practice.

‼️ The Claim Rejections report is only available to clinics using an integrated clearinghouse. Clinics using an outside clearinghouse will not be able to view this report. 

📉 Here's where to access the Claim Rejections report: 

Under Reporting, navigate to Billing and select the Claims Rejections report. 

📉 What information can I find on the Claims Rejections report?

The Claims Rejections report displays all claim rejections received, based on the date received. You'll see the patient's name, date of service, provider, payor, rejection reason, rejection dated, worked status, and more. 

At the top of the report, you'll see insights about your claim rejections: 

• Total Rejections: The total amount of rejections, based on your current filters. This number included worked and unworked rejections. 
• Total $ Impact: The total billed amount of all currently unworked claim rejections. 
• % Worked: The percentage of rejections that you have worked. 

By default, the report will list all rejections received within your selected date frame. You can filter the report so that the rejections are grouped by rejection reason, payor, and provider. 

When you select a “Group By” filter, the report will update so that each entry on the report is a “group." 

For example, here's what it looks like when you group by payor: 

• You'll see that by payor, you can see total rejections and the total billed amount for all rejected claims. 

Click on any “grouped” line item to view the individual rejected claims included in that group. 

📉 What does it mean to “work” a claim?

You'll see the Claim Rejections report includes a Worked column. 

A rejection is considered “worked” when the rejection message has been checked off and cleared from the claim. 

Here's what that looks like on the claim: