Resubmit Electronic Claims

When an electronic claim is rejected by the clearinghouse or payer, TherapyNotes will notify you by changing the status of the claim to rejected. Users with the role of Practice Biller or Biller for Assigned Patients Only will also receive a notification on their to do list prompting them to review electronic claim rejections. After making any needed corrections, these claims can be resubmitted through TherapyNotes.

Role Required: Practice Biller or Biller for Assigned Patients Only

When an electronic claim is rejected in TherapyNotes, the insurance status automatically changes to Pending Resubmission. You can view rejected claims for a specific patient by viewing their billing transactions.

To Locate a Rejected Electronic Claim:

Click Patients > Patient name > click the patient Billing tab
The Ins Status changes to Pending Resubmit for rejected claims. The image below shows where to locate the insurance status under the Patient Billing tab.

Go to the Submit Electronic Claims screen

First, go to the Submit Electronic Claims screen through one of these pathways.

Option 1: Click To-Do > Submit Electronic Claims

Option 2: Click Billing > Submit Electronic Claims

Option 3: Click Patients > Patient name > patient Billing tab > Submit Electronic Claims

Option 4: Click Patients > Patient name > patient Billing tab > Pending Resubmit

Option 5: Click Payers > Payer name > payer Billing tab > Submit Electronic Claims

Option 6: Click the Resubmit button on the Electronic Claim Details screen

Resubmit Electronic Claims

1) Status: The "Status" dropdown defaults to Pending Initial Submission or Resubmission, however you can select another option.

Note: If you are looking for a claim that was submitted through TherapyNotes, rejected by the payer, but not set as Rejected in TherapyNotes, select the option All Open Items.

2) Payer: Either leave the default Any Payer or select another option from the dropdown.

3) Clinician: Either leave the default Any Clinician or select another option from the dropdown.

4) Patient: Either leave the default Any Patient or click click to type in a patient name

5) Appointments: The date range defaults to Custom, but you can choose a different date range to enter.

6) Check off Dates of Service: Check off the dates of service you want to batch onto the claim.

Note: Claims are batched by patient. Conditions such as prior authorizations can split the batched claim of a patient into multiple claims.

7) Resubmission Type: Select an option from the dropdown.

New Claim means a newly resubmitted claim.
Amended Claim means a corrected claim. Selecting this option puts the number 7 on the corrected claim.
Void Claim should be used when the payer asks for a voided claim.

8) Payer Claim Control Number: If the payer asked you to resubmit the claim using a claim control number, enter it here. Contact the payer directly to obtain a claim control number. Claim control numbers are optional for New Claim and required for Amended Claim and Void Claim.

9) Review Claim Details: If you want to see exactly what is on the claim before submission, click the Review Claim Details link.

10) Submit Claims: After checking off the dates of service to resubmit, click the Submit Claims button to send the claims to the clearinghouse.

Track Claim Status with Electronic Claim History

After resubmitting the claims, track the status with the Electronic Claim History.

View a visual tutorial about how to track claim status with Electronic Claim History.

Enter Insurance Payments

Once you receive the explanation of benefits (EOB) or electronic remittance advice (ERA) and the insurance payment, post it to TherapyNotes.

View a visual tutorial of how to use ERA Payment Posting.
View a visual tutorial of how to enter insurance payments.

Additional Resources:

For a visual tutorial about how to submit electronic claims, see Submit Electronic Claims.