Permissions

Billing Permissions are needed

If you need to send a corrected claim (populate box 22 with a reference number) you will need to follow these instructions before you resubmit the claim.

Navigate to Billing > Insurers > Edit. Now under EDI file settings check the last box that reads "Ask for resubmission details prior to Re-Submit failed claim" and Save Changes.

Resubmitting a Claim

  1. Click Billing from the primary navigation bar.
  2. Locate the claim you need to update and send as a corrected claim, Select Update Status > Rejected/Denied.
  3. Navigate to the Rejected/Denied tab, select Actions (you may need to scroll to the right to see this tab) > View Invoice Details - this will take you directly to the invoice to correct anything that needs to be corrected.
  4. Correct the error in the client's profile or invoice and save the page where the update is being made.
  5. Return to Billing > Claims > Rejected/Denied and click Update Status. Choose Resubmit new claim. A dialogue box will pop up asking you to choose the resubmission code and enter the original reference number for the claim. What you choose will indicate to the payer that this is a corrected claim. Resubmission Codes = 7 - replacement of prior claim 8 - void/cancel of prior claim Original Reference Number- This is the payers claim number, sometimes also called an ICN or a control number. (you may need to call the insurance payer to get the Original Reference Number).

Resubmission details appear in Loop 2300 of the EDI file and Box 22 of form CMS1500:

If you need to correct the Service Type used on the original claim please click the article listed below.

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