Resubmit a portion of a previous claim

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Joined: Wed May 31, 2017 10:19 am

Resubmit a portion of a previous claim

Post by jsugal » Wed Aug 22, 2018 12:57 pm

Hi Gavin, It's Constance G.

I hope all is well. I have a question. I would like to resubmit a portion of a claim that wasn't paid and keep the same claim#. I noticed that a 96372 (admin injection) wasn't paid on a claim. The other parts of the claim were paid correctly. I went to the patient's case, deleted the adjustments and unchecked the "Apply payments to charges box" for all Ins Co. so the charge would " go back into Insurance" and the charge line turn black.
I then went to the Claim Manager and pulled up the claim. Under transactions, I removed the portions of the claim that were paid correctly. (I know that if I split a claim it creates a new claim # for the split portion and I didn't want that). After I changed the claim status to "Ready to send" the portion of the claim that I wanted to rebill submitted just fine. I did however notice that after I created claims for my other patients today, Medisoft also created a new claim for the portion of the claim that was paid correctly. I had to go back to claim Manager for that patient and change the status of the newly created claim to Done. Here are my questions? Doesn't it make sense to rebill a portion of a claim using the same claim number to cause less confusion for the Ins company (that is what I was told)? Is there an easier way to rebill a portion of a claim and keep the same claim number? Thanks for the information!

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Gavin Walker
Posts: 4255
Joined: Wed Apr 04, 2007 10:11 pm
Location: Springfield, MO

Re: Resubmit a portion of a previous claim

Post by Gavin Walker » Thu Aug 30, 2018 8:10 am

While it is possible to do corrected claims, Medisoft does not handle that very well. Instead I recommend you send a replacement claim. To do this, make all the changes to the claim so that it would be correct if you were sending the claim new today. Then go into Claims Management and edit the claim on the Carrier 1 tab enter 7 (for replacement) in Frequency Type.
Gavin Walker
Walker Tek Solutions, LLC

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