Denial Management
Manage and communicate claim denials to distributors
Total Denials (MTD)
234
12% vs last month
Denial Value
$847K
Rebates not payable
Pending Communication
1
849 not yet sent
Appeals Received
18
Awaiting review
Denied Claims
Select All
REQ-2024-001823
McKesson Corp • Denied Nov 24, 2024
Claimed Amount
$12,450.00
Line Items
8 denied
849 Status
Pending
Sent
Contract CTR-2024-0234 does not cover NDCs 12345-6789-01 through 12345-6789-08
REQ-2024-001819
Cardinal Health • Denied Nov 23, 2024
Claimed Amount
$8,234.50
Line Items
3 denied
849 Status
Sent
Claimed WAC $145.00 exceeds current WAC $138.50 by 4.7% (tolerance: 2%)
REQ-2024-001815
AmerisourceBergen • Denied Nov 22, 2024
Claimed Amount
$5,670.00
Line Items
12 denied
849 Status
Sent
Duplicate of REQ-2024-001756 submitted on Nov 15, 2024 (already paid)
REQ-2024-001810
HD Smith • Denied Nov 21, 2024
Appeal Pending
Date Outside Range
Claimed Amount
$3,890.00
Line Items
5 denied
849 Status
Sent
Transaction date 10/15/2024 falls before contract effective date 11/01/2024
Appeal: "Contract amendment dated 10/01/2024 extends coverage. Please review attached documentation."
Showing - of denials
Denial Reasons (MTD)
Contract Mismatch
34%
Price Discrepancy
28%
Duplicate Claim
18%
Date Outside Range
12%
Product Not Covered
8%
EDI 849 Queue
Recent Appeals
No pending appeals.
Appeal Review
- Request ID
- Distributor