Repair Claims

You use the Repair Claims button when a secondary insurance is added to the payer mix. This typically happens when a patient does not notify you of a secondary payer upon registration. The system will check all claims for the patient within the date range of the payer mix and then will change the payer index of each charge in the affected claims, if needed. Changing the payer index of the charges from Patient Responsibility to Secondary removes the obligation at patient and allows you to bill the claims to Secondary. Claims changed by the system will be set to On Hold.

  • After you have added the secondary insurance to the payer mix, click the repair claims button. This can be done from the Claim Editor (see below) or the Client Editor. The system will check for claims affected by the payer mix date range.
  • The front desk should be in the habit of clicking the button whenever a Secondary Payer is added to an existing payer mix and should notify the billing office if there were claims repaired.
  • Either a warning message displays indicating that the system found no claims that need repairing or the message that tells you which claim numbers were found that need repairing.
  • To copy the Warning message, select the pop up window, then use keyboard shortcut Ctrl + C. This message can be pasted into an email and forwarded to the billing office.
  • Click OK.

In the scenario below, the claims 1639, 1722, 1878, and 2013 were at Patient Responsibility and were found by the system after the Secondary Payer "Providence Health Plan" was added to the payer mix. Any amounts billable to the patient will be moved to the secondary payer index (2) and On Hold.

  1. Open the Claim Editor. Notice that the payer index is set to 2.
  2. Select Resubmit from the Action column to set the charges and claim to Billable.
  3. Click Save & Close.

Related Links:

Claim Editor Window

How to Bill Claims

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