Submit a Fully-Paid Claim to a New Primary Insurance

Submit a Fully-Paid Claim to a New Primary Insurance


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

  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].


If Changes need to be made on the Encounter

You must be attached to a Reference Batch


  • 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.


    • Related Articles

    • Insurance Management

      Insurance Management is used to manage a Patient's Insurance Profiles. The Primary, Secondary, and Tertiary Insurances are on one Insurance Profile. When the Insurance changes, a new Insurance Profile should be created. Insurance Management Insurance ...
    • Resubmit a Claim

      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 ...
    • Charge/Claim FAQs

      Charge/Claim FAQs Attachments How do I indicate there is attached paperwork? Attending What is an Attending Physician? An Attending Physician is the one who is responsible for the overall care of a Patient in a hospital or clinical setting. When is ...
    • Claim Submission Queue

      Claim Submission Queue Clearinghouse Schedule for sending Claims to the Payers On most mornings, Claims that are Clearinghouse Accepted are batched and forwarded to the Payers at 10:00 AM. (This is not a guaranteed submission time.) If Claims batches ...
    • Move Existing Encounters to a New Insurance/Self-Pay Profile

      When a new Insurance or Self-Pay Profile is added, you may need to move some of the existing Encounters to the new Profile. This most often occurs when a claim is denied for not being covered, and a new Insurance Profile needs to be added and ...