Resubmit a Partial Claim

Resubmit a Partial Claim


***Do not Delete or alter the Procedure Line if it has already been billed.***

See Submit a Claim with a Different Procedure Code.


Partial Resubmission

Resubmit specific Procedure Lines on a Claim (Partial Resubmission).

  1. On the Encounter Dashboard, select the Modify button.

    

  1. In the Procedure panel, select the Charge Line number link.

  1. Choose a Submit Status from the dropdown list:
  • If resubmitting one or two lines. Choose R (Partial Resubmit) on each line to be resubmitted.
  • Only lines flagged with R will be sent on the resubmitted claim.
  • If resubmitting all but one or two lines of multiple lines, choose X (Exclude from Claim) on each line to exclude it.
  • Only lines without the X will be resubmitted (they do not need to be flagged with an R).
  1. Select Save on the Modify Charge Line screen.

  1. Click Save [F2] on the Modify Charge screen.

    


Set to Ready for Submission/Resubmission
  

On the Encounter Dashboard, the lines are color-coded after the Submit Status is saved.

  • Red = line(s) to be Excluded
  • Green = line(s) to be Resubmitted

    


Resubmit a Claim with a Different Procedure Line

***Do not Delete or alter the Procedure Line if it has already been billed.***


If a CPT is being changed on a Claim that has already been sent to the Payer, follow these steps.

​

***Wait until the Original Claim has been adjudicated before sending the Corrected Claim.

  • If you do not wait for adjudication of the Original Claim, it poses posting challenges that are difficult to resolve.


Add a New Procedure Line/Change the Original Procedure Line to $0.00

  1. Add a Tag to the Encounter to hold until the Original Claim is adjudicated.
  2. After the Original Claim has been adjudicated, select the Modify button on the Encounter Dashboard.

  1. Check the Rebill checkbox on the top right of the Modify Charge screen.

  1. Add the new Procedure line(s).

  1. Select the Line number to change the Fee on the Original Procedure Code to $0.00, which prevents having to do a Write-Off later.

  1. Change the Fee to $0.00.
  2. Submit Status: Select Exclude from Claim.
  3. Select Save [F2].

  1. Claim: Select Replacement.
  • If the Payer is Medicare, who does not accept Replacement Claims, the System will automatically change it to Original with the addition of a Corrected Claim Note on the Claim.
  1. Select Save [F2].

  1. Make sure the Claim Status on the Encounter is Ready for Submission/Resubmission.




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