DENIAL RESOLUTION
Claim Denial Queue
Investigate denied claims with evidence-backed AI, then review and approve the next action.
4assigned to you
My QueueActive work owned by you.
Updated Jul 31, 10:00 AMRefreshing clinic work…
Recommended order
Overdue follow-ups and filing risk come first, followed by financial exposure and denial age.
How prioritization works
Only verified payer deadlines and active clinic follow-up dates affect time-based priority. Missing values are never treated as zero.
| Case | Problem | Next action | Waiting on | Owner | Due | Amount at risk?Unpaid amount tied to the current denial or rejection. It excludes recorded patient responsibility and contractual adjustments. | |
|---|---|---|---|---|---|---|---|
| SummitCare Benefit Plan | Claim matches a previously paid claimDuplicate claim | Follow-up is overdue; a matching paid claim means no payer call may be needed. | AR specialist | Melissa Carter | Overdue · Jul 30 | $210 | |
| SummitCare Benefit Plan | Timely-filing denial is not yet verifiableTimely filing | Filing deadline is not verified; missing payer receipt and policy evidence block readiness. | Clinic billing team | Melissa Carter | Aug 3 | $170 | |
| Cedar Health Plan | Authorization reference missingAuthorization | Approved authorization is on file; the $210 claim can move to correction. | AR specialist | Melissa Carter | Aug 1 | $210 | |
| Evergreen Community Benefits | Eligibility records conflictEligibility | Portal and 271 eligibility records conflict; coverage is not yet confirmed. | Payer verification | Melissa Carter | Aug 3 | $190 |