Rejection Due To A
Verification Failure (AG)
To reject a claim because of a
verification
failure, consider steps 1 – 9 below. The guide is
presented as follows
Working from the ‘Verification
Failures’ Work List
| 1 | If you are not already using Function
MAINTAIN WORKLIST
- Use Function MAINTAIN WORKLIST
|
| 2 | In Function MAINTAIN WORKLIST
- Select the ‘Verification Failures’ Work List from
the Worklist Type field. The claims appearing on the selected Work
List will be displayed
- Select the claim you want to reject by clicking on the
appropriate line to highlight it
- Select ‘File’ on the toolbar menu
- Select ‘Next Function’ from the options available.
You will be taken to the Select Next Function screen
- Select Function MANAGE VERIFICATION FAILURES. You will be taken
to the Manage Verification Failures screen
|
| 3 | On the Manage Verification Failures
screen
- Select ‘Navigate’ on the toolbar menu
- Select ‘Reject Application’ from the options
available. You will be taken to Function REJECT APPLICATION
- Select the reason(s) why the claim is being rejected
- Click on the [Add] button
- Click on the [OK] button
|
| 4 | You will be presented with the question
‘Are you sure you want to reject this application?’
- Click on the [Yes] button. The claim will be rejected and a
Rejection Notice issued
- If you have rejected the claim because the claimant has failed
to respond to your enquiries, go to step 9
Otherwise
|
Not working from the ‘Verification
Failures’ Work List
| 5 | From the Function Menu
- Select Function MANAGE VERIFICATION FAILURES and find the claim
you want to reject. You will be taken to the Manage Verification
Failures screen
|
| 6 | On the Manage Verification Failures screen
- Select ‘Navigate’ on the toolbar menu
- Select ‘Reject Application’ from the options
available. You will be taken to Function REJECT APPLICATION
|
| 7 | In Function REJECT APPLICATION
- Select the reason(s) why the claim is being rejected
- Click on the [Add] button
- Click on the [OK] button
|
| 8 | You will be presented with the question ‘Are
you sure you want to reject this application?’
- Click on the [Yes] button. The claim will be rejected and a
Rejection Notice issued
- If you have rejected the claim because the claimant has failed
to respond to your enquiries, go to step 9
Otherwise
|
Referral to Compliance
| 9 | (This text has been withheld because of exemptions in the
Freedom of Information Act 2000) |
