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

Payer inquiry

0 of 6 packet controls checked

A duplicate adjustment means the payer believes the same service was already submitted or adjudicated. The correct action depends on whether the prior claim is paid, pending, denied, voided, or materially different.

Triage checks

Find the original payer claim number and status.Compare patient, provider, code, modifier, units, charge, and date.Check whether a corrected claim was sent as a new original.

Evidence packet

Original and current claim comparisonPayer claim-history screenDistinct encounter, site, provider, or service documentation

Resolution sequence

01Do not send another unchanged original claim.
02If the prior claim is correct and pending or paid, close or post appropriately.
03If correction is needed, use the payer's replacement or void process.
04Dispute only when the claims are demonstrably distinct.

Open full denial guide Plan deadline