British Columibia Rejected Claims

Mary Jane -

Rejected Claims & Codes

 

NOTE: BC Health is always revising their rejected claim codes.

When a claim is rejected you will find a rejection code within the claim. You need to adjust claims before resubmitting them.

 

NOTE: CODE 44 IS THE ONLY CODE YOU CAN EDIT NAME, ADDRESS, HEALTH CARE OR PHIN #. ALL OTHER CLAIMS NEED TO BE CREATED FROM SCRATCH AGAIN.

 

Rejection Process:

1. Go to Accounting>Appointment claims.

2. Set the Status: to Rejected

3. Set your date range to ensure it covers the range the rejected claims would fall within and press Search.

4. Click the blue icon to the left of the item you want to work on and select Open Claim.

5. Rejection codes and explanation will be found in the bottom right corner.

6. Hover over the code to see why it was rejected.

7. Most rejected claims show a code 44 indicating the patient's demographics are incorrect. If this is the case click on the Edit Patient link beside their name and Edit.

8. Select the Resubmit button in the bottom right corner of the screen.

9. When you've updated all the rejected claims go to the claims search page.

10. When the next submission is sent these claims will automatically be resubmitted.

11. If you are unsure as to why a claim has been rejected you can print the Query form for the claim by clicking on the Query form link in the left side of the claim screen below the patient demographics.

 

Where to find Submitted claim rejection codes/reason

1. Go to Accounting>Appointment Claims.

2. Under the Status field select Rejected.

3. Click the blue icon to the left of the item and select Open/View claim.


Claims submitted rejection codes 2.JPG

 

Claims submitted rejection codes.JPG

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