A Payment Did Not Post

The Payment Is Not on the Claim

Resolve the item in Remittance Review to release the posting.

The remittance’s posting reads Held: it raised an exception, so its posting is held. Nothing lands on the claim until a reviewer closes the item. This is intended: money never posts on the strength of a match ClaimPod was unsure about.

Fix: work the item in the Remittance Review queue for the day the remittance arrived, and select Resolve. Work a Remittance Review Item covers it.

The Claim Was Never Filed From ClaimPod

This claim was never filed from ClaimPod, so the payer is answering a claim sent from elsewhere. Export the claim, then Recheck this remittance.

Fix: export the claim, then select Recheck on the remittance.

The Patient or Payer Does Not Match

{name} on the 835 may not be this claim’s patient - check the claim number.

{payer} paid a claim billed to another payer - confirm before posting.

The remittance matched a claim whose patient or payer differs from the 835.

Fix: check the claim number. If it is the wrong claim, reassociate it. If the money belongs to no claim of the practice, resolve it as Not Ours - Return to Payer.

The Remittance Matched the Wrong Claim

The payer’s control number pointed somewhere unexpected, or at nothing.

Fix: reassociate it onto the correct claim. When ClaimPod refuses, it moves nothing, which is deliberate.

Post Manual Adjustment or Post Reversal Is Missing

These need the Manager or Administrator role as well as User. Without one, they are missing from the card menus.

Fix: ask a Manager or an Administrator to post it.

The Adjustment Was Refused

Couldn’t post the adjustment - {the reason}. The ledger is unchanged.

An adjustment needs a group code, a reason code, and an amount that is not zero. The message names the one it refused on. An amount of $10,000,000,000 or more never gets that far: the amount field says “Enter an amount under $10,000,000,000.”

Fix: supply or correct what it names. The ledger really is unchanged, so nothing needs undoing before you retry.

The Reversal Was Refused

Already reversed - a posting can be reversed once.

Fix: none available. If the position is still wrong after a reversal, correct it with a new adjustment rather than a second reversal.

The Remittance Says Nothing Will Post

Nothing will post - this remittance carries no payment and no adjustments.

The payer sent an advice with no financial effect. This is normal and needs no action.

Nothing will post - a denial records its codes without moving the balance.

The payer denied the claim. The denied amount stays owed by the payer until a resolution decides it.

Write Off Was Refused

posting this remittance leaves a {amount} credit to the payer, which a write-off cannot settle - choose Refund to Payer instead

The payer paid more than the claim is owed, so there is nothing to write off.

Fix: choose Refund to Payer instead.

The Check Does Not Tie Out

The Check card shows Off by and the difference when the claim payments less the provider adjustments do not equal the check amount.

Fix: compare the claim payments and provider adjustments the card lists with the payer’s remittance advice for that check.

The Payer Says the Patient Died

CO-13 $80.00: patient died - check the date, then Reverse Charges (Void Claim if paid).

The payer denied the claim because its date of death comes before the date of service. Check the date of death with the payer or the practice first; if it is wrong, correct the patient and refile.

Fix: if the death is confirmed and the payer never paid this claim, choose Reverse Charges on the Remittance Review item. If the payer paid it on an earlier remittance, open the claim and use Void Claim first, so the payer is told to take the payment back; Reverse Charges closes the claim and Void Claim is no longer offered after it.

A Takeback Looks Wrong

Payers sometimes reverse in error. Releasing a takeback backs out the adjudication it reverses, using what that remittance actually posted. If that payment had moved a balance on to a secondary or tertiary claim, those are dealt with too: one not yet sent is voided, and one already sent opens an item in the Secondary Unwinds queue for a person to settle.

This takeback was not posted: this takeback’s amount matches no posted adjudication on the claim - reconcile it against the payer’s earlier remittance before releasing.

A takeback releases only when its amount mirrors one posted adjudication on the claim. Otherwise it stays held with this finding, and the remittance it would reverse keeps reading Posted.

Fix: confirm the takeback is correct with the payer before releasing it. Reversing an incorrect takeback is more work than not releasing it.

Related: Remittances · Transactions