Each denied claim is assigned to one or more of the following categories automatically when an EOB is received:
Authorization Denial — Issues with authorization or pre-approval
Benefits Denial — Issues related to patient benefits
Coding Denial — Incorrect or incomplete coding of services
Coordination of Benefits Denial — Errors related to determining the primary payer
Demographics Denial — Incorrect patient information
Diagnosis Denial — Diagnosis code issues
Duplicate Denial — Duplicate claim submission
Eligibility Denial — Patient not eligible for services on the date of service
Fee Schedule Denial — Discrepancy between billed amount and payer's fee schedule
Missing or Invalid Data Denial — Missing or incomplete information
Medical Necessity Denial — Service deemed not medically necessary
Payer Guidelines Denial — Non-compliance with payer-specific policies
Timely Filing Denial — Claims submitted after the payer's deadline
Other Denials — Miscellaneous denials that do not fall into the above categories
Each denial category has specific codes associated with it, which are pulled from the EDI 835 files or manual payment postings. Note that denials not associated with Contractual Obligations, Deductibles, Co-Pays, or Co-Insurance will appear on the Denials page for your team to review and take action.
Changing the Denial Category
In the Collections Module, users can manually change the denial category for a specific claim. To do this:
Navigate to the Collections Module and locate the invoice on the Collections page
In the denial column, select the Dropdown Menu to choose the appropriate denial category. The default option is "Not Applicable."
Once selected, the denial category is saved automatically — no additional confirmation step is needed
Denials Resubmission
Once the denial reason has been resolved and the necessary corrections have been made, the claim can be resubmitted to the payer. For full details on the resubmission process, including the important distinction between Save & Post, Resubmit, and Save, Post & Resubmit, see our Motivity Billing 101: Secondary Invoices, Adjustments, and Denials article.
Managing Denial Workflows
Each denial can have multiple workflows active at once, depending on the type of denial. For full details on assigning workflows, tracking progress, and managing steps through to resolution, see our Denials Workflow Management article.
Last Updated: 7/15/26 by Tatum Winslow