Internal complaint is Internal complaint is a claim resubmission type used if in case when the provider does not agree with the payer decision on specific activities. Only disputed activities are sent with an internal complaint.
Claim resubmission can be created for a claim in in Rejected By Payer or or Partly Paid By Payer statuses statuses.
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Step 1. Select (Incomplete)
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value from Status drop-down list.
The The search results grid appears. 
Step 2. Set focus on any claim and click
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Resubmit claim complaint
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Claim Claim Details dialog appears in edit mode.
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You can set / modify the following data here:
(1) resubmission comment;
(2) attachment;
(3) amount to resubmit.
Step 3a. Enter Enter any text in in Resubmis. comment. It is a mandatory field.
Step 3b. Click on Click on Add file for resubmission link link label. In the dialog appeared find the necessary file in in .pdf format format and click on Open button.
The file can represent medical report, lab results, prescription, authorization approval copy, purchase invoices or anything else the payer may request.
As 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 - and Attach file for resubmission
link label - link becomes available again.
Step 3c. Edit Edit Amount to Resubmit. Denial Amount is is copied here by default.
Denial Denial Amount = Net – Payment Amount
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If you want to resubmit all the amount denied, just leave Amount to Resubmit untouched.
Total amount to resubmit = sum (Amount to Resubmit)
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Step 4. Click Save Resubmission
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Claim Claim Details view closes. The claim status changes to to Ready for Resubmission.
As soon as the resubmission is created, Edit claim option option becomes available (learn[ more|Claim Edit]learn more). You still have an ability to modify the data before generating e-claims batches.