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First Training
How to log into myMPSOrientation of myMPS How to add a new user in myMPS How to add a new providerHow to add patients to myMPS How to capture an invoice Managing Patient AccountsAdding an appointment to the CalendarHow to conduct a Benefit CheckCustomizing calendar display settingsHow to capture additional claim information in myMPSNetwork Pricing contractsTransfer from Medical Aid liable to Patient liable How to create Templates and Favorites
Second Training
How to follow up on claims in myMPS Working with the myMPS inboxUsing myMPS ReportsHow to manage electronic remittances (eRAs)How to handle claim rejections via myMPSModifiersHow to transfer from Medical aid to patient liable Liability

How to handle claim rejections via myMPS

All rejected claims are found in the ‘Inbox’ tab under the ‘Claims’ menu.

These claim responses are divided into 2 categories:

  • ‘ Fix & resubmit - claim header ’. These are rejections based on incorrect member and ICD10 codes.
  • ‘ Fix & resubmit - claim lines ’. These are rejections based on incorrect claim line details, eg. tariff codes etc.

To fix a claim header.These rejections are based on incorrect member or practice details.

  • Select ‘Fix & resubmit - claim header’.
  • Click on the claim that needs to be fixed in order to open it.
  • Read the medical aid response and select ‘Fix claim and resubmit’ from the drop-down list and click on ‘Proceed’.
  • Click on ‘edit’ and update with the correct details and save.
  • Click ‘Save’ and then ‘ Submit ’ the claim.
     

To fix a claim line.These are rejections based on incorrect claim line details, eg. tariff codes etc.

  • Select ‘Fix & resubmit - claim lines’.
  • Select the claim that needs to be fixed, which will be highlighted in red.
  • Hover your mouse on the ‘ Reason Code’ of the rejected claim line in order to read the response.
  • Select the appropriate action from the drop-down list and click on ‘Proceed’.
  • Fix the claim line on the invoice screen and ‘ Submit ’.

 


 

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