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Documentation Index

Fetch the complete documentation index at: https://docs.encoreos.io/llms.txt

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The Denial screen displays a single claim denial record and provides status management and appeal creation at route /pm/denials/:denialId.

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Overview

The page loads a denial via useClaimDenialDetail. The Denial Details card shows denial date, category (from DENIAL_CATEGORY_LABELS), denied amount, CARC code with description (from joined pm_carc_codes), RARC code with description (from joined pm_rarc_codes), and denial reason. The appeal deadline field highlights in warning color if within 7 days and in destructive color if past due. Status-action buttons (In Review, Resubmitted, Resolved, Write Off) are gated by pm.denials.manage. The Appeals card lists linked appeal submissions with status badges (from APPEAL_STATUS_LABELS), appeal level, and created/submitted dates. Users with pm.appeals.submit can launch the Appeal Wizard (navigates to /pm/appeals/new?denialId=...) or open a Quick Draft via CreateAppealSheet.

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Who it’s for

Requires permission PM_PERMISSIONS.DENIALS_VIEW (enforced via RequirePermission in the route definition). Managing denials requires pm.denials.manage. Submitting appeals requires pm.appeals.submit.

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Before you start

  • You need pm.denials.view to access this page.
  • Navigate here from the Denials list (/pm/denials).

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Steps

1

Open a denial record

From the Denials list (/pm/denials), click a row to open the denial detail page.
2

Review denial details

Check the category, denied amount, CARC/RARC codes (with descriptions), denial reason, and appeal deadline.
3

Update status (pm.denials.manage)

Use the status buttons to move the denial to In Review, Resubmitted, Resolved, or Written Off as appropriate.
4

Create an appeal (pm.appeals.submit)

Click Appeal Wizard to navigate to the structured wizard, or Quick Draft to open the inline sheet.
5

Submit a draft appeal (pm.appeals.submit)

In the Appeals section, click Submit on any draft appeal to submit it.

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Key concepts

TermMeaning in code
carc_codeClaim Adjustment Reason Code; description joined from pm_carc_codes
rarc_codeRemittance Advice Remark Code; description joined from pm_rarc_codes
denial_categoryCategory label from DENIAL_CATEGORY_LABELS (SME confirm categories)
payer_appeal_deadlineDeadline date; turns warning/destructive based on proximity
DenialStatusnew, in_review, resubmitted, resolved, written_off
appeal_levelNumeric level of the appeal submission

Practice Management

Practice Management core overview.

Governance & parity

Documentation coverage and governance.
This page documents shipped product behavior. It is not medical, legal, or billing advice. Verify against your organization’s policies and applicable regulations before using it for clinical, compliance, or billing decisions. Protected health information (PHI) shown in the product is governed by your tenant’s access controls and is never exposed in this documentation.
  • src/routes/pm.tsx
  • src/cores/pm/pages/DenialDetailPage.tsx
  • src/cores/pm/hooks/useClaimDenialDetail.ts
  • src/cores/pm/hooks/useAppealSubmissionList.ts
  • src/cores/pm/hooks/useAppealSubmissionMutation.ts