An existing claim must be cancelled before it can be resubmitted. You can perform this task from the Patient's Claims Management Screen, or from the Patient Ledger.
Claims Management Screen
To cancel and resubmit a claim:
- From the Patient tab, select Insurance > Claims Management.
- Click on the claim line to expand the summary.
- Click Cancel Claim. You are prompted to confirm the action.
- Click Yes. The claim is canceled, and the procedures are added to the unbilled procedures list.
- Under Actions, select Create New Claim. The Create Insurance Claim window is displayed, containing a list of the patient's unbilled procedures.
- Select the procedure(s) you want to include in the claim.
- For Insurance to Bill, if there is more than one plan for the patient, you can select which plan to bill.
- Click Create.
When a posted procedure is adjusted or removed, you are prompted to cancel the associated claim and create a new one with the updated details.
- From the Patient tab, select Financials > Ledger.
- Select the ledger entry to expand the details. The claim number associated with the charge is displayed.
- Select Adjust This Charge.
- Click on the procedure to expand it, and select Adjust this Charge on the far right of the procedure line. The Adjust this Charge window is displayed.
Note: For more information, see How to Adjust or Remove Charges on the Patient Ledger.
- Select either Remove Entry or Correct Information and make the changes.
- Use the Adjustment Comments field to enter a comment or reason for the adjustment.
- Click Adjust Charge. You are prompted to confirm the action.
- Select Yes, Adjust Charge and Cancel Claims. The claim is canceled, and the Create Insurance Claim window is displayed, prompting you to re-create the claim with the adjusted information.
- Click Create.
Adding Additional Information
When you cancel and create a new claim, you can use the Edit Addl Info button on the Claim Summary area to add remarks or details needed for the re-created claim.