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Correct and Resubmit Rejected Claims from the Submitted Tab

Q: How do I correct and resubmit claims rejected by Clearinghouse?

1. Open the Claims Manager

1. Open the Claims Manager

To open the Claims Manager, click on the Billing menu then select Claims Manager.

2. Open the Submitted Tab

2. Open the Submitted Tab

Click on the Submitted tab.

3. Open Claim to be Edited

3. Open Claim to be Edited

To view the claim details for a submitted claim, double-click on the claim line.  This will open the patient account Claims tab and will display the selected claim.

This will allow the user to edit claims that have been submitted to the clearinghouse or receiver and rejected with errors prior to submission to payer.

If the rejection was for:

  1. Visit Information: Click the More Info button to edit visit information details.
  2. Charge Details: Double-click on the charge line to edit the charge details.

For instructions on making corrections to claims, please see: Correct and Rebuild an On Hold Claim.

4. Rebuild the Corrected Claim

4. Rebuild the Corrected Claim

After making the needed corrections to a claim:

  1. Click the Rebuild button located at the end of the claim line
  2. Enter any rebuild notes
  3. Click the Rebuild button

This will automatically move the claim back to the Pending Scrub section in the Working tab.

5. Re-Scrub the Claim

5. Re-Scrub the Claim
  1. Return to the Working tab
  2. Highlight the claim in the Pending section that was just rebuilt
  3. Click the Scrub button

6. Resubmit the Corrected Claim

6. Resubmit the Corrected Claim

If there were not errors found in the SOAPware scrubber, the claim will be moved to the Ready To Submit tab.

  1. Highlight the claim in the Ready to Submit tab.
  2. Click the Submit Selected button.

Claims Moved to Submitted Tab

Claims Moved to Submitted Tab

The resubmitted claim will now be moved back to the Submitted tab.