Rebilling (Resubmit Claims)

Providers can rebill a claim directly in the system; addressing any claims issues when initially submitting the claim.

Step

Action

1

Navigate to Billing > Electronic Billing > E-Submission Batches.

2

On the E-Submission Batches page click on the Add Resubmit Claims button.

 

The Add Resubmit Claims button displays on the top right of the E-Submission Batches page in the Batch tab.

Add Resubmit Claims

3

On the Add Resubmit Claims E-submission Batch page, select the Contract. The system automatically generates a Batch Number and the Batch Date for the claims resubmission. Click on the Add Claims button.

 

The Add Claims button displays at the top right of the Claims section on the Add Resubmit Claims E-Submission Batch page.

Add Claims

4

On the Add Claims, Claims Search page, select applicable filter fields and click Search.

 

The Claims Search section contains multiple search filter fields for claims. The Search button displays on the bottom left of the search filter fields section.

Add Claims: Claims Search
5

From the Search Results, select the claims to add and click on the Add button at the bottom of the page.

 

The Add Claims page displays selected checkboxes of resulting claims; users can click the Add button to add claims to the batch.

Add Claims

Note: Hovering over the Status icon provides a high-level indication of the state of the claim and possible missing information.

6

On the Add Resubmit Claims E-submission Batch page, click on the Edit Icon to open the Claims Adjustment window.

 

To delete a record from the claim to be resubmitted, click on the Delete Icon under the Actions column.

 

In the table of claims, users can click the Edit Icon to adjust the corresponding claim. Users can click the Delete Icon to delete a record for resubmission.

Select Claim to Adjust
7

The Claim Adjustment window opens. Select the Submission Type (refer to the Rebilling Adjustment Type section below for guidance). Correct any applicable fields ensuring that required fields (denoted with a red asterisk) are completed.

 

The Claim Adjustment page displays required fields denoted with red asterisks such as submission type, contract service code, caregiver pay code, billed rate, and visits per hour or daily visit.

Claim Adjustment Window

Note: The Billed Adjusted Hours, Travel Time (TT) Hours, and 3rd Party fields cannot be edited when resubmitting a claim.

8

Once saved and ready to resubmit, click on the Save Batch & Send button on the Resubmit Claims E-submission Batch page.

 

The Save Batch & Send button displays at the leftmost bottom corner of the Resubmit Claims E-Submission Batch page and table.

Resubmit Claim
9

The system alerts that the export file is generating. Click Close to continue.

The Information Window message informs users that the request for generating an export file has been created.

Information Window