Omit a Paid Charge when Refiling a Claim

Q: How do I omit a paid procedure from a claim when resubmitting unpaid charges to insurance?

1. Post Insurance Payments

When posting an insurance payment, you can omit a paid charge when refiling the claim.  For instructions on posting insurance payments, please see: Create an Insurance Payment.

2. Complete Charge Information and Omit Paid Charge

  1. Record the payment information for the paid charge (ex: 99215 was paid in the above screenshot).
  2. Check the Omit box for the line of paid charge(s).
  3. On the denied charge, enter the reason for denial into the Notes box.
  4. Set the Next Action to Refile.

3. Select Route & Insurance for Refiling

  1. Route: Select the route for refiling the claim (paper or electronic).
  2. File With: Select to file with Primary, Secondary or Crossover.

4. Save Claim

Click the Save Claim button.

5. Confirm Omitted Charges

5. Confirm Omitted Charges

Click the Yes button to continue with the omitted charges. Then click OK.

Once saved, the refiled claim will be moved to the On Hold section of the Claims Manager.

6. Rebuild Claim

  1. Open the Claims Manager by going to the Billing menu, then click on Claims Manager.
  2. Locate the claim in the On Hold section, then highlight the claim.
  3. Click the Rebuild button.

7. Scrub Claim

In the Pending section of the Claims Manager, highlight the claim and click the Scrub button.

8. Resubmit Claim

If there are no errors found in the SOAPware scrubber, the claim will be moved to the Ready To Submit section of the Claims Manager.  Select the claim, then click the Submit Selected button to refile the insurance using the indicated method (paper or electronic).