AI Claims Adjudication Workbench

835 Posting Rule Engine

Map CARC/RARC codes to posting actions: allowable, paid-to-patient, write-off, denial.

Posting rules
BHD10
Active
Custom Posting · Auto-post: Yes
Main condition
Submitted Charge Amount EQUALS Insurance Payment + Sum of Reason Codes
Allowable Reason Codes
Default: Bill Next
Inclusion
Group A
Exclusion
CO1CO10
Paid to Patient
Default: Patient Balance
Inclusion
PaidToPatient
Exclusion
Group B
Write Off
Default: Adjust
Inclusion
CO45CO253
Exclusion
Denial Reason Codes
Default: Hold
Inclusion
Group B
Exclusion
PaidToPatient