Viewing Denied Claims

Claim Denials are claims that were sent and accepted by the payer, but the payer has deemed the claim unpayable. There are a few ways to view your denied claims in Checkpoint. This is different from Rejected claims. Knowing the difference between a rejection and denial can save you time and confusion when contacting the payer and Checkpoint. Below are some key differences. 

	Rejection	Denial
Claim was accepted by the payer?	No	Yes
Will the claims department have the claim on file?	No	Yes
Where do the rejection or denial reasons in CP come from?	Payer	Payer
Which payer department do I contact with questions?	EDI Department	Claims Department
Where are the claims located in CP?	Billing menu-> Billing-> Claim Rejections	Billing menu-> Billing-> ERA Batch Files

How to View Denied Claims 

1. ERA Batch Files

ERA Batch Files will allow you to view electronic remittance advice (ERA) from all payers. ERAs typically post 2-3 days before or after you receive your payment from the payer. Follow the steps below to view the denials: 

1. Select the Billing Menu-> Billing -> ERA Batch Files.
2. By default, the last 30 days of ERAs are displayed. You can adjust the date range and/or sort by EFT # in the top middle of the page.
3. Click the  to view the content of an ERA. 
4. Under the section "ERA Records" the name, dates of service, and paid/denied amounts are displayed. Denied claims are marked with an indicator. 
5. To view the reason for denial, select the    under the section "ERA Records". 
6. The section will expand open, and denial reasons are displayed in yellow.

2. Client Sessions

Claims denials are also displayed under each client session. To view a denial for a specific client and date of service, do the following:

1. Select the Client Menu
2. Select the icon for the client you wish to view denials for. 
3. From the Client Sessions page select the $ to view denials/payments. 
4. Under the section "Payments" select the  to expand the section and view the denial reasons in yellow.