Denial Resolution Tool

Denial Evidence Packet Builder

Turn a denial family into a controlled checklist for triage, evidence collection, resolution routing, and prevention.

Use de-identified facts only. Do not type or print patient names, Medicare identifiers, claim numbers, dates of birth, medical records, or other protected information into this public tool.

Denial family

Likely route

Correct and resubmit

0 of 7 packet controls checked

The receiving payer or contractor is not responsible for the claim under the member, plan, jurisdiction, contract, or service facts.

Triage checks

Confirm exact plan and payer ID for the date of service.Verify provider contract and service jurisdiction.Check Medicare Advantage versus Original Medicare and DME MAC routing.

Evidence packet

Insurance card and eligibility responsePayer routing tableContract or jurisdiction sourcePrior denial notice

Resolution sequence

01Identify the responsible payer or contractor.
02Correct enrollment or routing data when needed.
03Submit promptly to the correct destination with prior processing proof if relevant.
04Protect the new payer's timely-filing deadline.

Open full denial guide Plan deadline