Correct a Processed Claim

If a claim wasn't paid as expected, you can correct the claim's information and resubmit it.

• If you need to correct a claim that was rejected, see Correct a Rejected Claim.
• If you need to correct a processed claim and a secondary claim has already been created, see Correct a Processed Claim After a Secondary Claim Has Been Created.

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View the Adjustment & Remark Codes

When a claim is processed by the payer, the remit you receive can include adjustment and remark codes that explain why each service was paid or not paid. Looking up these messages can help you identify why a claim wasn't paid as you expected.

1. Open the claim you want to look up codes for.
2. Click the Remittances tab.
   
3. In the lower-left, click Print Remittances
4. In the document that appears, look for the Adjustments & Remarks section.

Correct and Resubmit the Claim

Once you know why a claim wasn't paid as you expected, you can make corrections to the claim and resubmit it.

1. Open the claim you want to correct.
2. Make corrections to the claim's information:
   1. For any information that appears on the daily note (such as billing codes), return it to the therapist so they can update the document.
   2. For any changes that should also appear on future claims, make a correction at the source and then refresh the claim. For example, you can update the patient's insurance information on the patient.
   3. For any other fields, make a correction directly on the claim form
3. If the payer requires it, fill in box 22 with a resubmission code and the original reference number provided by the payer.
   
    
   1. Use resubmission code "7" if you want to replace the original claim with this new information.
   2. Use resubmission code "8" if you want to void or cancel the original claim.

      TIP! Follow the Payer's Rules: Some payers have specific rules about when to use a resubmission code. You may want to check with the payer if you are not sure how they process corrections.

4. If this is an electronic claim, click Send to Payer in the lower right.  Otherwise, resubmit the claim outside of Fusion.