If you receive a rejected Medicaid claim, don’t panic. Take a look at the explanation provided in the pamphlet, correct the error, and resubmit the claim.
Common Rejection Reasons
Rejected claims contain one or more errors that were located before the claim was processed or accepted by the payer. The main reasons for rejected claims are:
Additionally, you may have waited too long to file the claim, or the insurance company may have lost the claim and it expired. These aren’t the only reasons for rejected claims, but they’re common ones and they’re fixable. The best way to initially prevent rejections is by assessing patient eligibility—front-end staff should validate a patient’s demographic information, health insurance status, and coverage before submitting a claim to ensure a smoother path to an approved claim.
How to Handle Rejected Claims
Your insurance claim was rejected—what next?