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Pending Review
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Approved
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Rejected
Proposed Rule Updates
How Rule Proposals Work
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1. Upload Denials
Users upload ERA/835 data at the Report Denials page. Each denial is matched back to the original claim.
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2. Gap Detection
When a claim passed DenyZero but was denied by the payer, a rule gap is recorded. Patterns are tracked by CARC code and payer.
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3. Auto-Proposal
When a CARC/payer pattern hits 3+ denials, a proposal is auto-generated here. Approve to flag it for engineering implementation.