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