Resubmit a Claim (WebABA Pro & Group)

  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.

Jump to Section [Correct a Claim] [Resubmit Corrected Claim] [Rebill to the Proper Insurance]

Correct a Claim

1. Click Billing tab in primary navigation bar.
2. Click Claims in side navigation and click Rejected/Denied tab.
3. 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.

4. Then click Actions and select View Invoice Details.
5. Correct the error in the Invoice or Client Profile as appropriate.
6. Click Save.
   

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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:

1. Return to Billing > Claims > Rejected/Denied tab.
2. Find the client and select Actions>View EDI File.
3. A new window is opened displaying the EDI File.
4. Scroll down to Claim Information and use the Claim (CLM) number.
   In the example below it is the bolded number 00000031959T182
   
   
   

Resubmit the Claim

1. Return to Billing > Claims > Rejected/Denied tab and locate the Client.
2. Click Update Status and select Resubmit New Claim.
3. Select Resubmission Code in Resubmission Details window.
   • 7 - Replacement of Prior Claim
   • 8 - Void/Cancel of Prior Claim
     
     
4. 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).

   
   
   
5. Click Resubmit & Create New Claim.
6. 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.

Rebill to the Proper Insurance 

When a claim is rebilled, a date of service check is performed on the claim scrub. The system chooses the appropriate payer(s) to send the claim to based on the date(s) of service. If there are conflicts between the payer's effective coverage date and dates of service, the following error messages will display to let you know where the conflict is and how to resolve it. 

• When no payers are found for the service date(s), this error message displays. Click the link in the message to be redirected to the client's Bill To & Insurance tab to add an effective payer or change the payer coverage dates to match the date of service. 
  • Error message:No payers were found for the dates of service on this claim based on effective coverage dates. Please add a payer for this client. Click here to fix it.
    
    
• When multiple dates of service are on a claim that is across different payers, this error message displays. Click the link in the message to be redirected to the invoice where you can split the dates of service so one payer is attached to each invoice. Learn more about deleting & editing invoices.
  • Error message:Multiple payers are found for the dates of service on this claim based on effective coverage dates. Please delete the current invoice and split the dates of service so only one payer is attached to each invoice. Click here to fix it.
    
    
• When multiple payers are effective on the same date of service, this error message displays.
  Click the link in the message to be redirected to the client's Bill To & Insurance tab to make adjustments to the insurance effective dates. 
  • Error message:Multiple payers are found for the date of service on this claim based on effective coverage dates. Please adjust effective dates so only one payer is active for this invoice. Click here to fix it. 

Related Articles: 

• Common Rejection Codes and How to Fix Them
• Correct CPT Code for Submitted Claims 

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