A rejected claim was not accepted for processing by the clearinghouse or payer, usually because of formatting errors or missing or invalid data such as a wrong member ID. Unlike a denial, a rejection has no appeal: the claim is fixed and resubmitted.
Rejections should be corrected the day they come back, because the timely filing clock is still running.
Related terms
- Claim denial
- A payer's decision not to pay a claim that it received and processed.
- Clearinghouse
- A company that checks and routes electronic claims between providers and payers.
- Claim scrubbing
- Checking a claim for errors and payer rules before it is submitted.