How Do I Fix a Rejected Claim?

I received a rejection on my eClaim. I need to fix this and send it again, how do I do this?

When you are working with eClaims, we recommend resolving the issue at the source of the rejection, then pulling this corrected information into the claim using the Rebuild button and resubmitting the original claim. 

For example, if I sent a claim and later discovered that the patient's name is spelled without a hyphen for the carrier, I'd fix that on the record: 

I would then find the claim in the eClaims ability, select it and hit the Rebuild button to pull this updated information into the existing claim.

Once the claim is rebuilt, it will move to the Ready bin and I can submit it again.

This section of the HelpDesk contains more detailed instructions on common rejections.

Why can't I just create a new claim?

Rebuilding the claim provides clear tracking from start to finish. You can easily see the first time it was submitted and even prove this for timely filing if needed; using the trace number and the clearinghouse and payer messages. 

This is clearer on the ledger - The issue is corrected and the same claim is in the patient's history instead of multiple claims for the same charges. 

Prevent duplicate claims - Avoid any confusion that may be created by sending the same charges in on two different claims. 

When would I need to create a new claim?

There are 4 specific situations when a new claim should be created.

  • The patient has different insurance than what was sent on the first claim.
  • Prior Authorization Numbers need to be added to or removed from the claim.
  • Accept Assignment was set incorrectly on the original claim.
  • A different eClaim template should be used to submit this claim. 

What if this should be marked as a Corrected or Voided claim? 

First, verify this request with your carrier. Then fix the information at the source, rebuild the claim, mark it voided or corrected and resubmit it. Follow this article for more detailed instructions. 

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