Resubmit Claims Denied by Payer

When claims are denied by the Insurance Payer, PracticeQ makes it easy to correct and resubmit them.

When a claim comes back from the insurance payer as  denied, you must include a Resubmission Reference Number when you resubmit the claim. If you do not include this number, the payer will see the resubmitted claim as a duplicate claim, and reject it.

Locate the Resubmission Reference Number

As long as the ERA was sent through PracticeQ and our system processed it, you can obtain the number needed for resubmission in our system. 

1. Search for the claim or client in List → Claims → Payments.
2. Click the information icon on the right side of the payment
3. You will see two claim control numbers. You will need the Payer Claim Control Number as shown in the screenshot below.

Correct the claim and enter the resubmission number

1. Click Lists → Claims to review your claim statuses. 
2. Any claim denied by the Insurance Payer will display a yellow denied label in the Status column. 
3. Open the rejected claim.
4. Open the Actions menu at the bottom of the claim and select Edit Claim.
5. Edit the fields that require correction.
6. Scroll down to the Other Details section and find the box labeled Original Ref. No. (Resubmission). 
7. Open the dropdown menu and select the type of resubmission.
8. Enter the Payer Claim Control Number from the previous steps.
9. Resubmit the claim.