How to Correct Claim Exceptions

If ND MMIS finds exceptions when you validate or save claim information on the Claim Entry page or during claim adjudication, exception codes are posted to the claim. The exceptions are listed in the Claim Exceptions panel. Exceptions codes are posted to a claim when edits evaluate the claim data and find discrepancies including the absence of required data, or the presence of invalid data. You resolve exceptions on the Claim Correction page.

The Claim Exceptions panel is always displayed. As you scroll up or down the Claim Inquiry or Claim Correction page, the Exceptions panel moves up or down on the page.

Note: You cannot resolve exceptions on the Claim Inquiry pages. Claim Inquiry is only for viewing.

To work with exceptions

1. In the Claim exceptions panel, click the exception Code that you wish to review.

2. In the expanded panel, to display the first 50 characters for the resolution to this exception, click Resolution Text . 

   If you need more information about the exception, click the Read complete resolution text to go to the Claim Exception page of Rules Management, which displays detailed information for the exception. Click the Back button on your browser toolbar to navigate back to the Claim Entry, Claim Correction, or Claim Inquiry page.

3. Considering the resolution text provided, resolve the exception.
4. To redisplay the Claim exceptions panel with updated information, click Validate.
5. Repeat Steps 1 - 4 until you have resolved the exception codes.

See Also

Claim Correction (Claim Exceptions) Page

What Is Claim Correction?

What Is Claim Entry?

What Is Claims Inquiry?

About Claims

Version as of 5/16/14.