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 with Resubmission Details. This sends the Corrected Claim to the payer and populates box 22 with a reference number and resubmission code.
IMPORTANT: BEFORE resubmitting a Claim you must check the EDI File Settings and ensure Ask for resubmission details prior to Re-Submit failed claim is selected.
Correct a Claim
- Click Billing tab in primary navigation bar.
- Click Claims in side navigation and click Rejected/Denied tab.
- 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.
- Click Actions and select View Invoice Details.
- Correct the error in the Invoice or Client Profile as appropriate.
- Click Save.
Resubmit Corrected Claim
- Return to Billing > Claims > Rejected/Denied tab.
- Click Update Status and select Resubmit New Claim.
- In the confirmation window click Resubmit & Create New Claim.
- The claim is moved to the Resubmitted tab.
- Select Resubmission Code in Resubmission Details window.
- 7 - Replacement of Prior Claim
- 8 - Void/Cancel of Prior Claim
- Enter Original Reference Number - Payers Claim Number, also known as ICN or a Control Number (you may need to call the Insurance Payer to get the Original Reference Number).
Resubmission details appear in Loop 2300 of the EDI file and Box 22 of form CMS1500: