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

849 not yet sent

Appeals Received

Awaiting review

Denied Claims

Select All

REQ-2024-001823

McKesson Corp • Denied Nov 24, 2024

Contract Mismatch

Claimed Amount

$12,450.00

Line Items

8 denied

849 Status

Pending

Contract CTR-2024-0234 does not cover NDCs 12345-6789-01 through 12345-6789-08

REQ-2024-001819

Cardinal Health • Denied Nov 23, 2024

Price Discrepancy

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

Duplicate Claim

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 1-4 of 234 denials

Denial Reasons (MTD)

Contract Mismatch 34%

Price Discrepancy 28%

Duplicate Claim 18%

Date Outside Range 12%

Product Not Covered 8%

EDI 849 Queue

McKesson Corp

23 denials pending

Cardinal Health

15 denials pending

AmerisourceBergen

Sent Nov 25, 2024

Complete

Recent Appeals

18 pending

REQ-2024-001810

2 hours ago

HD Smith - Contract amendment claim

REQ-2024-001798

1 day ago

Morris & Dickson - Price correction