Work a Remittance Review Item
Clean payments post on their own. A remittance that raises an exception is held instead, and waits for you to judge it before any money moves.
Judge the Remittance
Section titled “Judge the Remittance”- In the sidebar, select Work Queues.
- Open the day’s Remittance Review queue.
- In the queue list, select an item. The list closes once you pick; to bring it back, select Queue. The workspace shows what the payer reported, the claim it matched, and the posting that is waiting.
- Read the findings in the Problems panel. Each names one exception, such as a payment posted under a different code than billed.
- Fix what the findings point at, or decide they are acceptable.
- In the bar at the bottom, choose a Resolution. Some ask for more: Appeal By for Appeal Denial, starting two weeks before the payer’s deadline; Bill To for Rebill to Another Payer; Method for Refund to Payer; the records and Response Due for Records Sent. The Changes panel lists what will post.
- Select Resolve. If someone else changed the remittance or its resolution first, the bar says your changes weren’t saved and offers Reload, which drops your edits (A Save Was Refused).
Result: the held posting releases and the entries land on the claim, and the processor advances to the next item. Not Ours - Return to Payer posts nothing, and a refused resolution, such as a takeback that matches no posting, leaves the item open with the reason.
Nothing Posts Until You Resolve
Section titled “Nothing Posts Until You Resolve”While a remittance is under review its posting is held. Saving a decision on the remittance page says so directly:
Resolve the item in Remittance Review to release the posting.
Money never lands against a claim on the strength of a match ClaimPod was unsure about - see The Claim Loop.
Resolving With Findings Still Open
Section titled “Resolving With Findings Still Open”If findings remain, the bar asks to confirm, for example Accept with 2 open findings?, rather than refusing outright. Some exceptions are informational, and a reviewer who has read them can accept them deliberately. Resolutions that move money, such as Reverse Charges, Write Off, Bill Patient and Refund to Payer, always ask first.
Related: The Remittance Page · Remittances · Reassociate a Remittance · Post an Adjustment