Rebill Claims Submission

On the Invoiced Visit Search page under Billing > Invoice Search > By Search, the TRN (Transaction Reference Number) can be manually edited or entered for UPR contracts to assist with electronic rebilling claim processes. Click the Y link in the Export Status column for a corresponding invoice to edit or enter a TRN number in the Update Export Flag to “No” window.

Additionally, the TRN Number is also editable at the Billing Info tab located at Patient > Search Patient > Calendar at the visit level.

Select	To...
Original	Default option; used if the Provider does not edit the Submission Type.
Adjustment	The TRN Number* and Update fields are required if Adjustment is selected. For the TRN Number, indicate if this adjustment is for a Single Claim, All Claims with same Invoice Number, or All Selected Claims. *TRN refers to Transaction Reference Number, unique claim identifier number to be adjusted. The TRN can also be referred to as the Form Number, Claim ID, or Claim Number. The TRN can is also located on the Electronic Remittance Advice (ERA).
Void	When selecting Void, the TRN Number is required and the Place Updated Visit on Hold checkbox is automatically selected and un-editable. Select the applicable Update option (Single Claim, All Claims with same Invoice Number, or All Selected Claims). Selecting Void hides other adjustment information fields on the window.

Upon adjusting, click Save to update the selected record(s). Based on the selected Submission Type, respective TRN Number, and Update option, the selected records are updated accordingly.

• If Single Claim is selected from the Update field, then only the current record for the selected Submission Type and TRN Number is updated.

• If the All Claims with same invoice number is selected from the Update field, then all matching records with the same Invoice Number are updated according to the chosen Submission Type and TRN Number.

• If All Selected Claims is selected, then all records are updated with chosen Submission Type and TRN Number.

For some contracts, Payers require a Condition Code for Providers to indicate the reason for resubmitting a claim. The Conditional Code field is used to provide a reason when changing the Submission Type of a resubmitted claim to Adjustment or Void.

When the feature is enabled for the Provider, the Condition Code field appears in the Claims Adjustment window under Billing > Electronic Billing > E-Submission Batches > Search > Claim Batch #. The values include the various codes assigned to the reasons listed.

In the Add Resubmit Claims E-Submission Batch page, the selected Condition Code appears under the Condition Code column in the listed claims.

1. Go to Billing > Electronic Billing > E-Submission Batches.

   

   This process is the same for UPR Linked Contracts and Internal Contracts

2. On the E-Submission Batches page click the Add Resubmit Claims button.

   

3. On the Add Resubmit Claims E-submission Batch page, select the Contract. The system automatically generates a Batch Number and the Batch Date for the claims resubmission. Click the Add Claims button.

   

4. On the Add Claims, Claim Search page, select applicable filter fields and click Search.

   

5. From the Search Results, select the claims to add and click the Add button at the bottom of the page.

   

   Hovering over the Status icon provides a high-level indication of the state of the claim and possible missing information.

6. On the Add Resubmit Claims E-submission Batch page, click the Edit icon to open the Claims Adjustment window

   

   To delete a record from the claim to be resubmitted click the Delete icon under the Actions column.

7. The Claim Adjustment window opens. Select the Submission Type. Correct any applicable fields ensuring that required field are completed.

   The Billed Adjusted Hours, TT Hours, and 3rd Party fields cannot be edited when resubmitting a claim.

   

8. Once saved and ready to resubmit, click the Save Batch & Send button on the Resubmit Claims E-submission Batch page.

   

9. The system alerts that the export file is generating. Click Close to continue.