How can I re-generate a claim for visits when the payor on the service was changed? (FAQ)

Solution:

There are instances where a service was configured for the incorrect payor and a claim was generated. The payor was changed on the service and billing needs to be completed for the new payor.

The steps below will guide you with resolving issues:

• Navigate to the claim(s) that were generated with the incorrect payor and void these claim(s) as your normal claim practices.
  • • Please note that a claim can only be void when in the status of Draft, Prepared, Paid, Denied or Rejected; if the claim is in Acknowledged, Accepted or Sent status the best practice is to wait for payment/rejection from payor first and there may be a disconnect when the payment or rejection is transmitted to ACC.
• Change the payor on the service using the following steps:
  • • Navigate to the client's profile.
    • Click on Care Management > Services.
    • Find the service linked to the visit(s) and click the 'Edit Service' button.

• Edit the Payor to the new payor.

• Click 'Save' to save the changes.
• Navigate to Claims and generate claim(s) for the new payor.

Notes:

• You can troubleshoot the issues explored in this article in your staging environment.
• If the issue is not resolved after going through the steps in this article, please search through other related Zendesk articles or have your super user submit a Zendesk ticket.
• For a full list of FAQs related to Claims, check out this section in Zendesk.