Resubmitting Rejected Claims

Claim Rejections from the Clearinghouse

No reference number is required to resubmit claim rejections from the clearinghouse.

Note for Office Ally users only:

• If a claim gets rejected by the clearinghouse, you’ll get an email with the claim number, error, segments and other claims that were a part of the batch that was rejected.
• If the entire batch is rejected, the rejected claim gets put in DRAFT and the rest get put in VALIDATED state so it’s easy to resubmit.

Claims Denied from Insurance Payer

Adding a Resubmission Reference Number

When a claim comes back from the insurance payer as DENIED, requiring fixes that need to be resubmitted, there is a reference code needed or else the payer will see a resubmitted claim as a new claim, and reject it.

To set this in place before resubmitting a claim, open the claim and scroll down to the "Other Details" section where you'll see a box labelled "Original Ref. No. (Resubmission)". You'd want to click the arrow to select the type of resubmission, and enter the code in the box.

Obtaining the Resubmission Reference Number

So long as the ERA came back in through practiceQ and our system processed it, you can obtain the number needed for resubmission in our system. Navigate to the claim payment itself, you can search for the claim or client in the payments view under "List > Claims > Payments".

You'll see an information icon on the right hand side of the payment, click it to see two claim control numbers. You're looking for the Payer Claim Control Number as shown in the screenshot below.