Troubleshooting Guide
Services or Claims Not Appearing
Find the specific encounter that should have generated a service.
Check the Encounters/Services screen to see whether a service exists.
Open the Rule Inspector by clicking the magnifying glass icon on the encounter. It shows exactly which service rules matched or failed, and why each input criterion passed or failed.
If the service rule configuration needs adjustment, make the change and rerun billing rules on the encounter.
If you're unable to identify the issue, contact support with the encounter details.
Service Rules Appear Correct but Services Aren't Generating
Confirm the client's admission date is on or before the encounter date.
Confirm the encounter type is marked as Billable in encounter configuration.
Confirm the client has an active funding source covering the encounter date.
Check for A/D/T issues — an incorrect re-admit date can prevent rule matching.
Use the Rule Inspector for a definitive diagnosis.
Claim Rejections
Confirm the payer is connected to Stedi for electronic claim submission. If not, this needs to be set up before claims can be submitted electronically.
If an enrollment is required for that payer, complete the enrollment through your Stedi account.
Read the rejection message carefully and fix the issue at its source in Ritten or the client chart.
Resubmit the corrected claim. If you're experiencing clearinghouse-level issues with a specific claim, contact Stedi support and reference the Correlation ID.
Modifier Not Appearing on a Claim
Verify the provider has the correct credential added to their user profile. A missing credential is the most common reason credential-based modifier overrides fail.
Verify the service rule override trigger is configured correctly.
Confirm the trigger condition is actually met for that encounter (correct payer group, attribute checked, etc.).
ERA Posting Issues
ERA is missing or taking a long time: Check your Stedi account for processing status. If the ERA isn't there either, contact Stedi support.
Silent upload failure: Log in to your Stedi account and check the file's processing log. A blank row at the end of the EDI file is a common cause.
Duplicate ERA: Ritten flags duplicate ERAs with a warning on the Remittance table. Delete the duplicate after confirming it is a true duplicate.
ERA routing to the wrong account: If your organization has multiple tenants sharing a Tax ID, each needs its own Stedi child account. Contact support for help setting this up.
Authorization-Related Claim Issues
Services splitting onto separate claims unexpectedly: Different authorization numbers (or one service with an auth and one without) force separate claims. Ensure all service lines on a claim reference the same authorization.
Negative Utilization Review balance: More units were billed than authorized. Review the affected claims to find and resolve the overbilling.
Authorization number not populating on the claim: Verify the authorization entry has the correct CPT code, date range, and modifiers to match the service.
Fee Schedule Issues
Add-on code billing at $0: Verify "Use Fee Schedule" is checked in the service rule's Advanced Options, and that the fee schedule has a row for that CPT code.
Service showing wrong rate: Fee schedule rates are captured at service creation time. Archive the service and rerun billing rules to pick up the updated rate.
Modifier rate not applying: Add an explicit CPT + modifier row to the fee schedule. Modifier combinations fall back to the base CPT rate if no specific entry exists.
Data Studio Copay Discrepancies
Data Studio calculates copay balances using PR-1 adjustment codes from remittance data, not manual payment entries. Copays collected through the calendar copay workflow will appear correctly. Manual copay entries will not.