Overview
After an appeal has been filed and processed by a payer, the payer may decide to overturn their original denial determination. If this occurs, the status can be updated in OneSpot.
Overturn Appeal
1. To begin, access the previously appealed claim in OneSpot (Aging>Claims>By Claim Status>Under Appeal). Then, select the applicable claim to open its 'Claims Details' and view the 'Appeals' tab.
2. Select the three dots to the left of the appeal.
3. Select 'Overturn Appeal.'
4. 'Date' will default to the current date, if needed this can be edited.
5. Enter a comment. This could include the payer's reason for overturning the original denial.
6. When finished, select ‘Save.’ If you do not want to save the information, select ‘Cancel.’
The claims status will be updated to ‘Completed - Paid,’ and the ‘Activity’ tab within the claim details will be updated as well.