Create a Corrected Claim

A correction in the RCM occurs when one or more components of information change, which alters the content of an existing claim.

Create Corrections

Once you have reviewed the changes and confirmed they are correct, the correction can then be generated by the user or the system. Let's review the process together!

1. Navigate to Work Center > Insurance Claims > Create Corrected Claims. 
2. Review the correction and click Resolve.
3. Select one of the following actions:
   • Create Corrected Claim to generate the correction.
   • Ignore to dismiss the correction.
   • Re-check in 24 Hours to instruct the system to ignore the corrections for 24 hours.
     
4. Enter the Internal Control Number to instruct the system to use 7 as the bill-type suffix/resubmission code.
   
5. Toggle on Submit as New Claim to bypass the ICN requirement.
6. When applicable, include Box 80 Remarks and Notes.
7. Next, tag an issue to the claim to help identify why the claim was corrected. Note that this information will not be in the claim.
   

8. Add any applicable condition codes.

   Note: If you want to have condition codes for record purposes but do not want to include them on the claim, create a Claim Form Rule to omit them.

   

9. Finally, click Resolve to complete the process.

Correction History

Every correction (or resubmission) that was generated or ignored can be found by navigating to the Record Center > Insurance Claims > Claim Instance Deviations or by navigating to the patient's profile. Let's review how to find the location in the patient's profile and recreate previously ignored corrections.

1. In the Patients section, locate the desired patient and click the Claim quicklink.
2. Next, click the Corrections History tab.
3. Locate the previously ignored correction and click Update.
4. Finally, follow steps 3-9 outlined above to complete the process.

Correction Troubleshooting

Refer to our correction overview article for more information on corrections and how to troubleshoot them.