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).
To resubmit a claim
How to get there
On the Home menu, under Insurance, click (or tap) Sent Claims.
The Sent Claims page opens.
How to get there
Use the Patient Search box to access a patient's record.
Notes:
If the last patient record you accessed since you last logged on is the correct patient's record, you do not need to re-enter the patient's name in the Patient Search box.
You can include inactive patients in the search results by setting the Include inactive patients switch to On.
On the Patient menu, under Insurance, click (or tap) Insurance Claims.
The patient's Insurance Claims page opens.
How to get there
Use the Patient Search box to access a patient's record.
Notes:
If the last patient record you accessed since you last logged on is the correct patient's record, you do not need to re-enter the patient's name in the Patient Search box.
You can include inactive patients in the search results by setting the Include inactive patients switch to On.
Do one of the following:
On the Patient menu, under Financial, click (or tap) Ledger.
The patient's Ledger page opens.
The Claim Detail dialog box appears.
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:
On the Status/History tab, locate the reason that the claim was rejected (it may be identified by a Document Control Number, DCN, or Claim Reference Number) within the Note of an entry in the status history list.
Copy and paste the reference number (from step a) into the Original Ref Number field.
On the Claim Info tab, make any necessary changes.
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:
On the Status/History tab, locate the reason that the claim was rejected (it may be identified by a Document Control Number, DCN, or Claim Reference Number) within the Note of an entry in the status history list.
Copy and paste or type the reference number (from step a) into the Original Ref Number field.
Also, on the Status/History tab, locate and copy the attachment reference number (it may be identified by a DCN) in the status update history list.
On the Claim Info tab, make the necessary changes.
On the Attachments tab, add or correct the attachments, and type or paste in the Attachment Ref Number (from step c).
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:
On the Status/History tab, locate and copy the attachment reference number (it may be identified by a DCN) within the Note of an entry in the status history list.
On the Attachments tab, add or correct the attachments.
Type or paste in the Attachment Ref Number (from step a).
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:
On the Status/History tab, locate the original reference number (it may be identified by a DCN) within the Note of an entry in the status history list.
Copy and paste or type that reference number (from step a) into the Original Ref Number field.
Under Specific Payer Requests, click (or tap) Replace Claim.
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