SpokeChoice Help

Prev: <a href="https://ddreports.screenstepslive.com/s/13723/m/53682/l/1724528-fixing-claims-in-the-submitted-state">Fixing Claims in the submitted State
Next: <a href="https://ddreports.screenstepslive.com/s/13723/m/53682/l/1430627-setting-up-collaboration">Setting Up Collaboration

Billing Denial Reasons

Submitting a billing file to DDD through Wellsky could result in many types of denials.

Some of those are as follows

Claim Denied, reason=Q0225 - CLAIMS DID NOT MATCH ELECTRONIC VISIT VERIFICATION DATA. This is typically something that has gone wrong during a visit or billing change. See checking sandata for more information.
precertification/notification/authorization/pre-treatment exceeded. This is a FOCUS issue in which only DDD can fix. Please submit a ticket to have them fix it.
Rate not Authorized. This can happen if you have the wrong rate associated to the billing code in SpokeChoice. If the rate is correct then it is a DDD/FOCUS problem and needs to be addressed with a ticket to the department.