Resubmit a Claim
***Do not Delete or alter the Procedure Line if it has already been billed.***
Resubmit a Claim
When a Primary Claim is resubmitted, the full amount of the Charges is always sent on the Claim, even if the Claim total is zero.From the Encounter Dashboard, select the Change Status button.
Choose Ready For Submission/Resubmission on the Payer that you are resubmitting the Claim.
Add a Note if applicable.
Select Save [F2].
Resubmit Multiple Claims in One Step
In the Encounters by Status panel on the Home Dashboard (if pinned) OR Claims > Claims Management Dashboard > Encounters by Status panel.
Select the number link under Primary/Secondary/Tertiary/Patient/Total columns to review the claims.
After reviewing the claims, select the Encounters to Resubmit by selecting the checkboxes or use the Select All button.
Select the Change Status button.
On the Popup, choose Ready for Submission/Resubmission.
Add a Note if applicable.
Choose the Select All button.
Resubmit a Claim with a Changed CPT
If a CPT is being changed on a Claim that has already been sent to the Payer, select this link for resubmitting: Resubmit a Partial Claim.
Resubmit a Zero Balance Claim
If one of the CPT Codes is a zero balance, and it is on an Encounter that has a balance, then the Claim is submitted a usual.
If all line items on a Claim equal zero, the Claim is not automatically resubmitted to the Payer.
Resubmit a Claim with a Zero Balance to Payers on the Current Insurance Profile
Manually change the Claims Status to Ready for Submission/Resubmission on the Encounter Dashboard by using the Change Status button.
If this is being sent to a Secondary or Tertiary Payer, be sure to choose the correct Payer before selecting Ready for Submission/Resubmission.
The Status displayed on the Encounter is Ready to Submit Zero Balance.
This Claim will batch when the next Claim Batch is created.
Resubmit a Claim with a Zero Balance to a Different Payer
Example:
The wrong Insurance was billed and has been paid.
The Insurance that paid will take back the Payment.
You want to bill the correct Insurance while waiting on the Takeback from the original Insurance.
Resubmit
In Insurance Management, create a new Insurance Profile with the correct Insurance.
The Claim Status will be set automatically to Ready for Submission and will batch the next time a new Claims Batch is created.
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