Resubmit a Corrected claim (TheraNest)

  Permissions You must have Billing Permissions.

To resubmit a corrected claim, you will need 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.

NOTE: In order to resubmit a corrected Claim you will need to ensure that Ask for resubmission details prior to Re-Submit failed claim in the EDI File Settings is selected for this payer.

Resubmit a  Corrected Claim

1. Click Billing tab in primary navigation bar.
2. Click Claims in side navigation bar and locate your claim. 
3. Click Update Status and select Rejected/Denied.
   NOTE: If your claim is in the ERA Received Tab you will click Actions > Mark Claim as Rejected
4. Navigate to the Rejected/Denied Tab and locate your claim 
5. Click Update Status > Resubmit New Claim
6. Select Resubmission Code in Resubmission Details window.
   • 7 - Replacement of Prior Claim (Corrected Claim)
   • 8 - Void/Cancel of Prior Claim
7. Enter the Original Reference Number -  This is the Payers Claim Number, also known as ICN or a Control Number. 

Resubmission details appear in Loop 2300 of the EDI file and Box 22 of form CMS1500:

NOTE: If your claim is in the Paid Processed tab and you need to Resubmit a Paid Claim that is in the Paid/Processed Tab.