The Primary Insurance on File was Paid in Error

The new Insurance was not obtained at the time of the visit, and the old Insurance was billed and paid.

• The correct Insurance is obtained from the Patient.
• While waiting on the takeback/refund from the incorrect Insurance, you want to bill the new Insurance.
  

The full amount is sent on a Primary Claim regardless of amounts another Insurance has paid.

If there are no changes that need to be made on the Encounter

• Add the New Insurance Profile and move the Encounter to the new Insurance.

1. Go to Insurance Management  
2. Add New Insurance Profile  
3. Choose the Encounter(s)  
4. Select the Change Profile/Rebill button.
5. Choose the Re-Bill button  
6. Add a Note if desired.
7. Save [F2].

• When the takeback/refund occurs, post to the original Profile.

If Changes need to be made on the Encounter

You must be attached to a Reference Batch

• Reverse the Encounter for Modification

• Reversal Options

• Uncheck UNDO Payments
• Uncheck Rebill Primary

• On the New Encounter Dashboard, select the Insurance Management link to add the new Insurance Profile, and move the new Encounter.

• Uncheck Rebill.

• On the New Encounter Dashboard, select the Modify button.
• Make Changes: Units/Fee or add a new CPT®.

• If there is an existing CPT that should not be sent to the new Insurance, mark to Exclude it.

• Leave original CPT® and Fee Amount. DO NOT delete it or zero the amount.
• When the original Insurance does the Takeback/Refund, post it to the appropriate line items.

• If the line item was not sent to the new insurance, adjust off the CPT after all Insurance is adjudicated.

• Save the Modify Charge screen.