Denial Worklist Overview

Denial Worklist Overview

The Denial Worklist is populated when an ERA is applied, and at least one line item on the Remit has a zero dollar Payment and is statused to DW on the ERA Remit Items screen.

  • The Denial Worklist is interactive with links to the:
  • Encounter Dashboard
  • Patient Dashboard
  • ERA
  • Remit
  • Receipt
  • In the Claim Type column, the plus icon can be used to:
  • View whether this is a Primary, Secondary, or Tertiary Payer.
  • Line item details
  • CARC and RARC codes
  • Charge, Allowed, and Paid Amounts
  • Tags Column: Displays Tag(s) if the Encounter has a one or more Tags attached to it.

  • Use the Filter Criteria to define the content of the list.
  • (Home > Denials button in the Actions panel.
  • There are fewer options on this Worklist than the other Worklists in the System.
  • If you want more options when working the DW, the Remit can be added to another designated Worklist using the ERA Remit Items screen.

Example of DW: ERA 1532 was Applied. Encounter 5081 was denied and did not Post. It was placed on DW by the System due to a zero dollar Payment.


Access the Encounters on Individual ERAs placed on the Denial Worklist

  • On the ERA File Dashboard by selecting the number in the DW box;


Access all Encounters on the Denial Worklist


Denial Worklist Filters

The Filters can be used to narrow the DW list.

  • View: Summary or Detailed view.
  • Remit and ERA: Enter a Remit or ERA Number.
  • Patient: Enter a Patient ID or use the Lookup icon to search for a Patient.
  • Include Zero Balance Encounters: Select the checkbox to include Encounters that have a zero balance.
  • Encounter, Receipt, Insurance, Denial Code, Facility, Rendering, and Billing: Use the Lookup icon on the respective fields to filter for specific items.
  • Takebacks: The options are Inclusive, Exclusive, Only
  • DOS From and DOS To: Search using a range of Dates of Service.
  • Patient and Insurance Bal >= and <=: Filter for specific balances.
  • Charge, Paid, Applied, and Unapplied Amounts >= and <=: Filter for the specific criteria using greater than/equals to and/or less than/equals to.
  • Unapplied Only: Select the checkbox to view unapplied Payments only.
  • Include Inactive: Select the checkbox to include Inactive Patients.
  • Tags and Tag Attributes: Search by Tags and/or Tag Attributes.
  • Resolved Tags: Include, Exclude, or Only.


Denial Worklist Columns

  • Interactive Columns: Remit, Patient, Encounter, ERA, and Receipt
  • Other Columns
  • Name: Patient's Name
  • Assigned Encounter Tags
  • These Tags also display on the Encounter
  • There is a flag on the Encounter showing that the Encounter is on the Denial Worklist.

  • Facility: The office where the Patient was seen.
  • Encounter Insurance: The Patient's Insurance on the Encounter
  •  Ins Bal and Pat Bal: Insurance and Patient Balances
  • Claim Type: How the Claim was processed: Primary, Secondary, or Tertiary

  • Lines: Number of Line Items on the Claim
  • DOS: Encounter Date of Service
  • Charge: Total Amount of Charges on the Claim
  • Paid: Total Amount that has been paid
  • Applied and Unapplied: Amounts of the Total Paid that have been applied and unapplied.


Example of On Hold Remits on the ERA Remit Items screen:

  • ERA 1528 was Applied.
  • Three Encounters did not Post and were placed on Hold by the System.
  • Remit 7936, Encounter 6806, was placed On Hold because a credit would be created if posted.


Learn More

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