Resubmit a Claim (TheraNest)

  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.

NOTE: See Resubmit a Corrected claim for claims that have been denied by the insurer.

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

 

Correct a Claim if Needed

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 your Claim is not in the Rejected/Denied tab you need to Resubmit it. Locate the Claim. Click Update Status and select Rejected/Denied. This will move it to the Rejected/Denied tab where you can Resubmit.

4. 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 Claim

1. Return to Billing > Claims > Rejected/Denied tab.
2. Click Update Status and select Resubmit New Claim.
3. In the confirmation window click Resubmit & Create New Claim.
4. The claim is moved to the Resubmitted tab.

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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