What is the difference between a rejected claim and a denied claim?

Last Updated March 3rd, 2017

A claim rejection occurs prior to claim processing and is typically related to input errors or invalid data. A denied claim is processed by the payer and determined to be unpayable. In both instances, the payer will return a notification for the reason of rejection or denial. PokitDok has edits in place to limit the amount of claim rejections in an effort to keep our percentage of “clean” claims high.


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