How Do I Resubmit an Online Claim

Use this exercise to resubmit an online claim.

Complete the following steps to finish this exercise:

  1. On the Provider Account Management pull-down menu, select the Provider Billing menu option.  A sub-menu displays.

  2. Select the Search sub-menu option.  A sub-menu displays.

  3. Select the Claims sub-menu option.  The Search Claims page displays.

  4. Select the appropriate radio button and enter filter criteria in the following fields as necessary to perform a search:

  5. Claim #

  6. Authorization #

  7. Provider Acct

  8. Last Name (Provider)

  9. First Name (Provider)

  10. Child Id

  11. Last Name (Child)

  12. First Name (Child)

  13. Check Number

  14. EFT Number

  15. Type

  16. Start Date

  17. End Date

  1. Click Search to perform a search based on the filter criteria entered.  The Claim List page displays.

  2. Click the icon in the Detail column for a specific claim.  The Claim Detail page displays.

  3. Click the Correct Claim button.  The claim entry page (specific to the claim you are resubmitting) displays.

  4. Click the icon in the Detail column for a specific line.  The line entry page (specific to the line you are correcting) displays.

  5. Complete all of the required information on the claim entry page to enter a line for the claim.  Fields marked with an asterisk (*) are required.

  6. Click Update Claim to save your information.  The claim entry page (specific to the claim you are correcting) displays.

Tip:  All line items are displayed for the claim.  The total dollar value of all of the line items on the claim is displayed in Claim Total Charges at the bottom of the page.

  1. Click Check Claim to perform the application's validation edits on the claim without submitting the claim.  (You can still update the claim if necessary when checking a claim.)

Tip:  After the system validation edits are complete, you are shown whether the claim will pass or fail when it is submitted.  At this point the claim has not been saved to the database and may be corrected if necessary.  Individual line items may still be added to the claim, updated on the claim, or deleted from the claim. The Check Claim button may be clicked multiple times to perform many checks on the claim until the claim is actually submitted.

  1. Once the claim entry is complete and has been checked thoroughly, click Submit to save the claim to the database.

Note:  A claim that has been updated or paid may still be corrected by clicking the Resubmit Claim button on the Claim Detail page.  However, once the date of service is over 120 days, the claim can no longer be resubmitted.