Exceptions & denials
Most cases move through Synaipse cleanly. This page covers the ones that don’t — the exceptions that need follow-up before billing, and the denials that come back after a claim is submitted.
Exceptions
An exception is a case Synaipse can’t finish on its own and that a quick review won’t resolve — usually because information is genuinely missing or contradictory.
- Name
missing_documentation- Description
A required detail (such as laterality or a specimen result) isn’t in the note.
- Name
incomplete_note- Description
The operative note appears to be a draft or is missing a signature.
- Name
conflicting_data- Description
The note conflicts with the matched encounter — for example, a different procedure than scheduled.
- Name
duplicate- Description
The note appears to duplicate a case already processed.
Exceptions are grouped separately from the worklist so they don’t block routine review. From an exception you can request the missing documentation, correct the patient match, or dismiss a false duplicate.
Catching missing documentation before a claim goes out is the cheapest place to fix it. Synaipse flags these gaps at intake, so you can request an addendum while the case is fresh rather than after a denial weeks later.
Denials
When a payer denies a claim, the fastest appeal is one backed by the documentation. Because Synaipse keeps every code linked to the exact language in the operative note, the evidence for an appeal is already assembled.
- Open the denied case to see the codes that were billed and the note passages supporting each.
- Compare the denial reason against the documented evidence.
- Use the linked source language to build a corrected claim or an appeal with the supporting note attached.
Reducing denials over time
Denials are also a signal. Synaipse tracks denial reasons across your cases so you can see patterns — a procedure that’s frequently downcoded, a payer with a recurring documentation requirement, a modifier that’s often missed. Acting on those patterns upstream (in templates, documentation habits, or your routing rules) is where the durable improvement comes from.