Permissions You must have Billing Permissions.
If a Claim was Rejected, you have the ability to correct that Claim and then resubmit it as a Corrected Claim (which will populate box 22 with a reference number).
NOTE: In order to resubmit a corrected Claim you will need to ensure that Ask for resubmission details prior to Re-Submit failed claim in the EDI File Settings.
Jump to Section [Correct a Claim] [Resubmit Corrected Claim] [EDI File Settings]
Correct a Claim
- Click Billing tab in primary navigation bar.
- Click Claims in side navigation and click Rejected/Denied tab.
- Locate appropriate Claim and make note of the Rejection/Denial Details.
IMPORTANT: If you Claim is not in the Rejected/Denied tab but you need to Resubmit it, locate the Claim. Click Update Status and select Rejected/Denied. This will manually move the Claim into the Rejected/Denied tab.
- Then click Actions and select View Invoice Details.
- Correct the error in the Invoice or Client Profile as appropriate.
- Click Save.
Resubmit Corrected Claim
- Return to Billing > Claims > Rejected/Denied tab.
- Click Update Status and select Resubmit New Claim.
- Select Resubmission Code in Resubmission Details window.
- 7 - Replacement of Prior Claim
- 8 - Void/Cancel of Prior Claim
- Enter Original Reference Number - Payers Claim Number, also known as 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:
- Common Rejection Codes and How to Fix Them
- Correct CPT Code for Submitted Claims - How to correct the Service Type used on the original Claim.