The first thing to do when a case is rejected for pricing is read the rejection comment carefully. The facility reviewer will usually tell you exactly what they need. Here's how to handle the most common scenarios.
First — can you see the rejection reason?
If the rejection comment is blank, showing an error code, or displaying a message like "item not found" instead of a readable explanation, skip the scenarios below. Submit a ticket by clicking the chat icon in the bottom right corner with your DO# and a note describing exactly what you're seeing. Our team will investigate and tell you what the rejection reason is and what needs to be corrected.
If you can read the rejection comment, continue below.
Scenario 1 — The item is flagged as not on contract
The item either is not covered under the active agreement at that facility, or it is under a different contract section than what is loaded in Helia. What to do:
Check if the item should be covered under a specific contract or local agreement. If you have a contract number that supports it, submit a ticket by clicking the chat icon in the bottom right corner with the item number, DO#, facility name, and contract number. Our team will investigate.
If you do not have a contract number, check with your corporate team before resubmitting.
Follow the health system's not-on-contract policy displayed in the app — if the item needs to be removed, remove it. If a price needs to be entered, follow the policy.
Scenario 2 — The price doesn't match what the facility has on file
This means there is a discrepancy between what is loaded in Helia and the facility's contract data. Before escalating, ask yourself honestly:
Did your corporate team communicate a new contract, a pricing amendment, or a local agreement at this facility?
Do you have a contract number or amendment reference that supports a different price?
If yes — submit a ticket by clicking the chat icon in the bottom right corner with the item number, DO#, the price showing in Helia, the correct price from your records, and the contract number or amendment reference. Our team will investigate.
If no — do not resubmit at the same price. Check with your corporate team first to confirm what the correct price should be and where it comes from. Once updated pricing is confirmed live, delete and re-add the item before resubmitting so the correct pricing populates.
Scenario 3 — The case was submitted to the wrong facility
If the case was submitted to the wrong facility location — for example, a specialty or satellite location instead of the main campus — pricing will look different because each facility has its own contract. What to do:
Confirm with your corporate team or order management system which facility the procedure was actually performed at.
If it is the wrong facility, you may need to create a new case under the correct facility. Submit a ticket by clicking the chat icon in the bottom right corner with both DO#s and our team will advise on the best path forward.
Scenario 4 — The quantity or unit of measure is wrong
If the rejection comment mentions quantity or unit of measure, this is something you can fix yourself. Open the case, tap the item, correct the quantity or unit of measure to match your records, and resubmit.
After our team confirms a pricing fix
Once you are notified the correction has been made, do not resubmit at the old price. Delete the affected item, re-add it from the catalog — the updated pricing will populate — then review the full case and submit.
Note: Do not substitute a different item while waiting for a correction — substitutions create reconciliation issues that are difficult to fix after the fact.
Still need help? Click the chat icon in the bottom right corner to submit a ticket.