Medical Billing Forum

Billing => Billing => : Midwife January 18, 2010, 09:07:05 PM

: Help with resubmission
: Midwife January 18, 2010, 09:07:05 PM
Can someone help me with instructions on re-submitting claims to Medicare?
: Re: Help with resubmission
: Michele January 19, 2010, 11:54:19 AM
Are they corrected claims, or just not received the first time?
: Re: Help with resubmission
: Midwife January 20, 2010, 12:01:00 AM
They will be corrected claims that were denied for different reasons.
: Re: Help with resubmission
: Pay_My_Claims January 20, 2010, 12:20:16 AM
what system are you using, and it depends on the denial. Sometimes you have to submit a NEW claim, otherwise you can (if your system allows) fix the correction and just resubmit. Its kinda hard to say unless we know the software you are using. With one system I used, if the correction resulted in a change in the charge, we had to file on a charge which resulted in another fee from the clearing house. otherwise we just could resubmit it.
: Re: Help with resubmission
: Michele January 20, 2010, 10:07:13 AM
Charlene's right, depends on what denials, and what system.  But generically speaking, if you are submitting a corrected claim because information on the charges was corrected and you are submitting on paper, we attach a brief letter to the front explaining what happened.  Nothing fancy, just a brief explanation.

Michele
: Re: Help with resubmission
: Midwife January 20, 2010, 04:11:29 PM
I am asking about Medicare in particular.
We use APEX billing software.
For insurance and Medical we can re-submit the claim electronically.
For Medicare I understand that you have to re-submit the original denial.
The PROBLEM is I think that we inadvertenly deleted the original files from Easyprint that
contained the denials.  I am working on that separately.
I was wondering what the PROCEDURE is for re-submitting to Medicare.

: Re: Help with resubmission
: Pay_My_Claims January 20, 2010, 04:16:06 PM
even with Medicare, I have resubmitted the claim after it was corrected as if it was a new claim.  If you look at the EOB, it will tell you if the claim is not re processable  It will state, resubmit as a new claim
: Re: Help with resubmission
: Michele January 20, 2010, 11:42:01 PM
Easyprint usually archives the eobs and you can bring them back.  Again, it really depends on the reason for submitting the corrected claim, but generally speaking we submit the corrected claim on paper, with an attachment explaining what was corrected.

Michele