How to Resubmit a Claim

There are times when you will need to resubmit a claim. There are two ways to move a previously submitted claim back to Billable status. You can either resubmit a claim using the Resubmit button in the Claims F4 tab, or you can use the Claim Editor to resubmit the claim. You may need to resubmit a claim for the following reasons:

  • The claim is not on file with the payer.
  • You need to include chart notes with the claim.
  • You need to appeal a denied claim.
  • You have updated a patient's payer mix with new insurance information and need to bill the new insurance.
  • You have corrected an insurance ID number.

Option 1: Resubmit One or More Claims in the Claims F4 Tab

  1. Log in to INSIGHT Billing.
  2. From the Claims F4 tab, select the claim you need to resubmit.
  3. Use the Resubmit button in the Claims tab to move a claim that is sitting in the Mixed, On Hold, or At Payer category back to the Billable category.
  4. Select the claim and click the Bill button.
  5. The Create Bills window displays. Select the claims to process, print or process the EDI file.
  6. Select OK.

Option 2: Resubmit a Single Claim Using the Claim Editor

  1. Log in to INSIGHT Billing.
  2. Locate and open the Claim Editor in one of the following ways:
    1. From the Claims F4 tab, locate the claim.
      1. Use the Research button or filter by name to find the patient.
      2. Double click the claim to open the Claim Editor.
    1. From the Accounts F7 tab, locate the claim.
      1. Use the drop-down arrow to select the patient name.
      2. From the Claim Details subtab, click to open the Claim Editor.
  3. Once the Claim Editor is open, use the drop-down arrow on the Action column to select Resubmit.
  4. Select Save & Close. The Claim Version Note dialog displays.
  5. Optional: Enter a note providing a brief explanation of why you are resubmitting the claim. (For example, billed correct insurance, updated ID number, added modifier, etc.) This note displays on the version after the claim is re-billed.
  6. Click OK. The claim now moves to back to Billable on the Claims F4 tab.
  7. Follow steps 4-6 from Option 1 to bill the claim.

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