Round 2, partial approvals, and carrier responses

The carrier responded. Now what? This article walks through recording what they said, reading the outcome breakdown, understanding partial approvals, and starting a Round 2 supplement if items are still in dispute.

What this step is

After you submit your supplement package, the carrier will respond — usually in writing, sometimes by phone. They'll approve some items, deny others, and partially approve a few. ClaimOps tracks each line item across every round so you always know exactly where the money stands.

Round 2 is a second supplement scoped only to the items still in dispute. You don't re-fight approved items — you focus your energy where it still counts.

Why it matters

Most carriers don't approve everything on the first round. Partial approvals are common — the carrier agrees on the category but disputes the quantity or price. If you don't track exactly which items are still open, you risk missing money or re-arguing things that are already settled.

ClaimOps keeps a running record of every round — what was asked, what was approved, and what's still in dispute. That history is your leverage when you go back to the carrier.

What to do

1. Open the claim and go to “Record carrier response.” From the claim detail page, you'll see a card that says “Record carrier response” once your Round 1 supplement is marked submitted. Click it and upload the carrier's response letter or EOB as a PDF.
2. Wait for ClaimOps to process the response. ClaimOps reads the carrier's letter and matches each line to your original supplement items. This usually takes under two minutes.

After uploading the carrier's letter, ClaimOps shows the processed response on the claim detail page.

3. Review the outcomes breakdown. ClaimOps shows each line item with its outcome: Approved, Partially approved, Denied, or Needs review. The recovery bar at the top shows how much of your supplement ask was approved in dollar terms.

The outcomes view breaks down every line item the carrier responded to.

4. Use the Triage step to confirm which items to fight in Round 2. Before ClaimOps builds a Round 2 package, it shows you the items still in dispute and asks you to confirm which ones you want to fight. This is important — if you skip the Triage confirmation and go straight to generating Round 2, ClaimOps has to scope the full ask again, which affects the recovery percentage display. Take a minute to confirm your triage before generating.
5. Click “Start Round 2.” Once you've confirmed triage, ClaimOps sets up a Round 2 supplement scoped to the disputed items. Your Round 1 history stays intact.

Round 2 is scoped to the items still in dispute — you don't re-fight what was already approved.

6. Strengthen and generate the Round 2 package. Same process as Round 1 — add stronger evidence for the disputed items, then generate the supplement. The Round 2 package focuses on the specific denials or partial approvals and explains why each item should be reconsidered.

The Strengthen tab in Round 2 shows only the disputed items — keep your focus narrow.

The completed Round 2 package — ready to review and send to the carrier.

What to check before moving on

• Every item in the outcomes list has a clear status — no blanks or “needs review” items you haven't looked at.
• You've confirmed the Triage step before generating Round 2 (not just clicked straight through to Generate).
• The recovery percentage in the Round 2 header looks reasonable for your claim. If it's over 100%, contact support — that shouldn't happen.
• You've read the Round 2 PDF, especially the reasoning on each disputed line.

Common mistakes

• Generating Round 2 without confirming Triage. If you skip the Triage confirmation, ClaimOps doesn't know which items you actually want to fight — so it defaults to scoping the full ask again. This makes the recovery percentage look lower than it really is (your denominator doubles). Always confirm Triage first.
• Uploading a partial or low-resolution carrier letter. If the PDF is a scan at low quality, ClaimOps may not read all the line items correctly. Use the clearest version you have. If the response was verbal or by phone, make a brief written record of what was said and upload that.
• Sending Round 2 without reviewing it. The Round 2 package references the carrier's specific denials. Read it first to make sure the reasoning matches your records. An error in Round 2 is harder to walk back.

Where to get help

If the carrier response isn't processing, the outcomes look wrong, or you're not sure how to read a partial approval — reach out before moving forward.

• Back to Help center
• contact@claimops.io — we aim to respond within 24 hours.