Denied claims are claims that were received and processed (adjudicated) by the payer and a negative determination was made. You cannot resubmit this type of claim. It must be researched in order to determine why the claim was denied, so that you can write an appropriate appeal or reconsideration request.
If you resubmit this type of claim without an appeal or reconsideration request, it will most likely be denied as a duplicate, costing you even more time and money the longer the claim remains unpaid.
Claim rejections are different than claim denials. Claim rejections are claims that do not meet specific data requirements or basic formatting that are rejected by insurance according to the guidelines set by the Centers for Medicare and Medicaid Services. These rejected medical claims cannot be processed by the insurance companies as they were never actually received and entered into their computer systems.
This type of claim can be resubmitted once the errors are corrected. These errors can be as simple as a transposed digit from the patient’s insurance ID number and can typically be corrected quickly.