Resubmitting rejected claims

You can resubmit a claim that has been rejected by an insurance company due to incorrect or missing required attachments and/or due to missing or insufficient data. A claim that needs to be resubmitted has a status of Rejected by eServices (REJECTSV), Rejected by Payer (REJECTED), Unprocessable Claim (UNPROCESS), Additional Information Requested (ADDINFO), or NEA Error (NEAERROR).

Tip: You can access rejected claims from the Unresolved Claims box on the practice Overview page (dashboard).

Note: Editing and resubmitting rejected claims requires the "Edit Insurance Claims" and "Send Insurance Claims" security rights.

To resubmit a claim

1. Click (or tap) a claim on one of the following pages:

   • The Sent Claims page.

     

   • A patient's Insurance Claims page.

     

   • A patient's Ledger page.

     

   The Claim Detail dialog box appears.

   

2. Do one of the following:

   • If the claim has missing or insufficient data only (the attachments are fine), enter the original reference number, change any other claim information, and resubmit the claim.

     Do the following:

     1. On the Status/Notes tab, locate the reason that the claim was rejected (it may be identified by Document Control Number, DCN, or Claim Reference Number) within the note text of an entry under Notes.

        

     2. Copy and paste or enter the reference number (from step a) into the Payer Claim Reference # box.

     3. On the Claim Info tab, make any necessary changes.

        

     4. Click (or tap) Resubmit.

   • If the claim has missing or insufficient data and has incorrect or missing required attachments, enter the original reference number, enter the attachment reference number, change any other claim information, and then resubmit the claim.

     Do the following:

     1. On the Status/Notes tab, locate the reason that the claim was rejected (it may be identified by Document Control Number, DCN, or Claim Reference Number) within the note text of an entry under Notes.

        

     2. Copy and paste or enter the reference number (from step a) into the Payer Claim Reference # box.

     3. Also, on the Status/Notes tab, locate and copy the attachment reference number (it may be identified by DCN) within the note text of an entry under Notes.

        

     4. On the Claim Info tab, make any necessary changes.

        

     5. On the Attachments tab, add or correct the attachments, and enter or paste the attachment reference number (from step c) into the Attachment Ref # box.

        

     6. Click (or tap) Resubmit.

   • If the claim has incorrect or missing required attachments only (the other data is fine), to send or resend the correct attachments directly to NEA (National Electronic Attachments) without resubmitting the entire claim, enter the attachment reference number, and then resubmit the attachments.

     Do the following:

     1. On the Status/Notes tab, locate and copy the attachment reference number (it may be identified by DCN) within the note text of an entry under Notes.

        

     2. On the Attachments tab, add or correct the attachments.

        

     3. Enter or paste the attachment reference number (from step a) into the Attachment Ref # box.

     4. Click (or tap) Submit Attachments.

   • If the payer has requested a replacement claim, to resubmit the claim as a replacement for the original (the claim is routed differently than with a normal resubmission), enter the original reference number, and then replace the claim.

     Do the following:

     1. On the Status/Notes tab, locate the original reference number (it may be identified by DCN) within the note text of an entry under Notes.

        

     2. Copy and paste or enter the reference number (from step a) into the Payer Claim Reference # box.

     3. Click (or tap) Replace Claim.