Permissions You must have Billing Permissions.
To resubmit a claim that was rejected or not on file with the payer mark the claim as Rejected and Resubmit with Resubmission Details. This sends the Corrected Claim to the payer and populates box 22 with a reference number and resubmission code.
IMPORTANT: BEFORE resubmitting a Claim you must check the EDI File Settings and ensure Ask for resubmission details prior to Re-Submit failed claim is selected.
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
Before you can Resubmit a Corrected Claim, you will need the 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).
IMPORTANT: Before You Begin
Get the Original Reference Number (Payers Claim Number, also known as ICN)
To get the Claim Number in WebABA:
- Return to Billing > Claims > Rejected/Denied tab.
- Find the client and select Actions>View EDI File.
- A new window is opened displaying the EDI File.
- Scroll down to Claim Information and use the Claim (CLM) number.
In the example below it is the bolded number 00000031959T182
Resubmit the Claim
- Return to Billing > Claims > Rejected/Denied tab and locate the Client.
- 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
NOTE: This is the Payers Claim Number, also known as ICN you retrieved above in Get the Original Reference Number (Payers Claim Number, also known as ICN).
- Click Resubmit & Create New Claim.
- The claim is moved to the Resubmitted tab.
Resubmission details appear in Box 22 of form CMS1500 after this process is completed.
NOTE: ONLY check Resubmission details not required for this claim. if you are correcting a rejection from the clearinghouse.