What's the difference between a claim rejection and a denial?

A rejection happens before adjudication — the clearinghouse or payer bounces the claim for a format or data error, so it never processes and must be corrected and resubmitted. A denial happens after adjudication — the payer processed it and decided not to pay, which is what you appeal. Confusing the two wastes time: you appeal denials and you correct-and-resubmit rejections.

What actually matters

• Rejection = pre-adjudication bounce for a format or data error — correct and resubmit
• Denial = post-adjudication decision not to pay — appeal it
• A rejection has no appeal rights, because it was never processed
• Catch rejections fast so they don't age into timely-filing problems
• Never appeal a rejection — fix and resend it

Common questions

Where Volari fits: Volari classifies rejections out of the appeal path — you never file an appeal on a claim that was never processed.

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