To fill box 22 of the CMS 1500 claim form: Resubmission Code/Original Reference number, first select "Ask for resubmission details prior to Re-Submit failed claim" in the EDI file settings of the Insurer Details page (Billing > Insurers).
- Click Billing > Submitted Claims.
2. Mark the claim as failed to process by clicking Mark As > Failed to Process.
3. Correct the error in the client's profile or invoice and save the page where the update is being made.
Resubmit the claim by clicking the Re-submit edi file button.
4. If you enabled, "Ask for resubmission details prior to Re-Submit failed claim" in the EDI file settings to populate box 22 of the claim form, enter the required resubmission details:
Original Reference Number (you may need to call the insurance payer to get the Original Reference Number).
6. Click Re-Submit.
Resubmission details appear in Loop 2300 of the EDI file and Box 22 of form CMS1500: