Duplicate Claims (Clearinghouse/Payer)
Duplicate claims occur when the clearinghouse/payer receives multiple claim files. They process the initial submission and any additional submissions will get rejected as a duplicate within a 24 hour window.
You can see this in the bottom right corner of your eClaims window when you select one of these claims. The duplicate rejection will have a different trace number than all the other reports. It will show as a rejection until you get further information back on the claim that Change Healthcare sends on to the payer, so you may want to keep an eye on them in case there is a rejection on the original claim for anything else. That being said, you should be able to move the duplicate claims from the rejected bin to the accepted bin as there is an attached claim that has been processed by the clearinghouse; making sure to check for other rejections first.
There are a few reasons we get rejections for duplicate claims. Occasionally claims are effected by an interruption in the network. This is where the program thinks the claim did not send because of the interruption, and sends them again. This is more common for offices that experience other network issues, slowness, or have computers running on wireless; MacPractice recommends an ethernet connection for all computers. This is similar to sending someone a text message and even though you only send one, the recipient sometimes will receive two. There isn’t much we can do to prevent these types of errors, but knowing how to fix them is important.
Claims can also duplicate when MacPractice crashes during the sending process, or the program has been force quit. This will cause the sending process to stop and there is no way to resume where it was left off. At things point claims get resent, and can occasionally be marked as duplicate.
Additionally it is possible to click 'send' in MacPractice more than once. If the button gets clicked while the initial send it going on, it will likely duplicate the file and send twice.
Paying close attention to claim reports from both the clearinghouse and payer can help sort out any duplicate claim confusion. If there is a duplicate rejection from the clearinghouse, but also have an acknowledgement from the payer, the claim can be moved to the Accepted bin because it has been forwarded to the payer. Again, be sure to check the reports for additional rejections, as the duplicate may not be the only one listed.
If the duplicate rejection is from the payer it it likely that they have the original claim submission on file. Please contact the payer for claim status.