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What do claim statuses mean in Barti, and how do I fix a rejection?

A claim in Hold is ready to submit; Draft means it still needs to be scrubbed or updated. If a claim is rejected, corrections must be made in TriZetto before resubmitting.

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Written by Dan Healey

Who this is for: All Barti RCM users who create or manage claims.


Claim statuses

Status

What it means

Draft

The claim still needs to be reviewed, scrubbed, or updated before submission.

Hold

The claim is ready to be submitted to TriZetto.

Pending

The claim has been submitted to TriZetto and is being processed.

Approved

The claim has been approved by the payer.

Partial

The payer has approved part of the claim but not all line items.

Paid

The claim was approved and funds have been released.

Rejected

The claim was rejected. The rejection reason is visible inside the claim in Barti.

Error

Transmission to TriZetto failed. The claim can be resubmitted directly in Barti without creating a new claim.


How to fix a rejected claim

All rejected claim corrections must be made directly in TriZetto, not in Barti. See How does Barti work with TriZetto? for background on how the two systems interact.


Common rejection types

"Invalid Information" (no specific details provided)

TriZetto hasn't specified which field is incorrect. Contact TriZetto customer support to get the exact rejection reason before making any changes.

"Insured/Subscriber — Invalid Information"

The member ID on the claim is incorrect or the patient's policy is inactive.

  1. Go to the patient's profile in Barti and check the member ID on file.

  2. Correct the member ID if needed.

  3. Resubmit the claim through TriZetto.

"Provider Not Approved"

The provider is not enrolled to submit electronic claims to this payer.

Contact TriZetto customer service to begin the enrollment process for that provider and payer.


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