Claim correction is a resubmission type used in case when provider wants to resubmit complete claim. Claim resubmission can be created for a claim in Rejected By Payer or Partly Paid By Payer statuses.
Step 1. Select Select (Incomplete) value from Status drop-down list.
The search results grid appears.
Step 2. Set focus on any claim and click on Resubmit claim correction link label.
Claim Details dialog appears in edit editing mode.
You can set / modify the following data here:
(1) member info: Member ID, Emirates ID, Contract package name;
(2) resubmission comment;
(3) attachment;
(4) visit info: Encounter Type, Encounter Start, Encounter End;
(5) diagnosis info: Type, Code; add / delete diagnosis;
(6) activity info: Type, Code, Tooth No's, Start Date, Quantity, Net, Clinician, Prior Auth.; add / delete activity.
Step 3a. Enter any text in Resubmis. comment. It is a mandatory field.
Step 3b. Click on Add file for resubmission link label. In the dialog appeared find the necessary file in .pdf format and click on click Open button.
As a result, new options actions appear:
- View attached file link label – – by clicking on it the file opens for viewing;
- Remove attached file link label – – by clicking on it the file removes from the claim and Attach file for resubmission link label becomes available again.
Step 3c. Edit visit info, e.g. change Encounter Start / Encounter End dates.
Step 3d. Edit diagnoses:
- to add a diagnosis: click on Add new link label, select Type and set Code in the new line appeared;
- to remove a diagnosis: highlight any diagnosis and click on Delete link label.
Step 3e. Edit activities:
- to add an activity: click on click Add new link label, set activity details in the new line appeared;
- to remove an activity: highlight any activity and click on click Delete link label.
By clicking on Set activity start to encounter start for all activities link label Start Start Date column values set as Encounter Start.
Step 4. Click on Click Save Resubmission button.
Claim Details view closes. The claim status changes to Ready for Resubmission.
As soon as the resubmission is created created, Edit claim option becomes available (learn more). You still have an ability to modify the data before generating e-claims batches.