Introduction

Motivity- Denials Management Module

The Denials Management Module in Motivity provides a dedicated platform for efficiently managing claim denials from payors. Denials can occur when payors reject all or part of a claim due to discrepancies in the data or failure to meet certain requirements. The denials may involve issues with authorizations, patient eligibility, coding errors, or missing information. This module helps manage the process of correcting claims and resubmitting them, ensuring that denied claims are tracked and resolved efficiently.

Scope and Purpose

The Denials Management Module is designed for larger practices where the team responsible for handling denials is separate from the team that posts payments, and where coordination across teams is required to resubmit claims accurately and promptly.

Process Overview

• Identifying denials from payors.
• Classifying denials into specific categories (e.g., authorization denials, coding denials).
• Correcting the necessary information.
• Resubmitting claims to the payor for payment.
• Tracking denial workflows and assigning tasks to relevant team members.

This module integrates seamlessly with the existing billing and collections features in Motivity and provides visibility into each claim’s denial status and progress.

Accessing the Denials Management Module

To access the Denials Management Module, navigate to the Collections menu. Under Collections, you will see two submenus:

1. Payments: The current collections page.
2. Denials: The new denials page for managing rejected claims.

Denial Tiles

At the top of the page, there are multiple tiles representing different categories of denials. Each tile shows:

• Denial Category: The type of denial (e.g., Authorization Denials, Coding Denials).
• Count of Claims: The number of claims under that category.
• Denied Amount: The total dollar amount denied for each category.

Clicking on a tile filters the list of claims displayed on the page, allowing you to focus on specific types of denials.

Filters

Filters allow users to refine the displayed data based on various parameters:

• Funding Source Type
• Funding Source
• Office
• Assigned To
• Denial Category
• Workflow Type
• Workflow Step

Search and Sort Options

The Search Bar enables users to quickly find specific claims by entering the following:

• Patient Name
• Patient ID
• Invoice Number

The Sort Options allow users to organize denials based on:

• Denial Age: How long the claim has been denied (based on the EOB date).
• Patient Name: Sorting can be performed within funding sources to either display the oldest denials first or organize patients alphabetically.