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 6 packet controls checked

This denial family commonly indicates that another payer may have primary responsibility or that primary-payer adjudication data is missing or inconsistent.

Triage checks

Verify all active coverage for the service date.Determine primary responsibility under the applicable COB or MSP rule.Check whether the primary EOB or 835 data reached the secondary payer.

Evidence packet

Eligibility and coverage responsePrimary payer EOB or ERAEmployment, accident, ESRD, or other payer-order facts

Resolution sequence

01Correct payer-order records when inaccurate.
02Bill the correct primary payer.
03After primary adjudication, submit a compliant secondary claim with COB data.
04Use the appropriate Medicare coverage-development channel when CMS records are wrong.

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