Payer Rejected: Not Eligible

Payer Rejected: Not Eligible

The Claims with this Payer Rejection did not make it into the Payer adjudication system. If you call the Payer, they will not have a record of this claim.

Options

  1. Call the Patient for updated Insurance information or
  2. Go to the Encounter Dashboard and move the Encounter to Self Pay to create a Statement when Statements are run.
  3. For an ERA, post the $0.00 payment and drop the responsibility to the Patient.
    1. If you do not want to write off the balance, do not post the CO codes because that will drop the balance to zero, and the Patient will not get billed.

Move the Encounter to Self Pay

  1. If there are Transactions posted that are not Patient Payments or Copays, the Encounter cannot be moved to Self Pay.
  2. If there are no Transactions or the only Transaction Codes on the Encounter are PP, PIPPR, Or PIPPB.
    1. Select Insurance Management on the Encounter Dashboard.
    2. Highlight the Insurance Profile where the Encounter is located.
    3. At the bottom of the screen, select the checkmark box beside the Encounter number.
    4. Select the Change Profile/Rebill button.

    1. Uncheck the Re-Bill checkbox.
    2. For the New Profile, select Self Pay from the dropdown.
    3. Select Save [F2].


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