When you submit a claim electronically through Fusion, the clearinghouse or payer may reject the claim, indicating that something about the claim was invalid and could not be processed. If this happens, you can correct the claim's information and resubmit it through Fusion.
If you need to correct a claim that was processed by the payer, follow the instructions to Correct a Processed Claim instead.
In This Article
View the Rejection Reason
When a claim is rejected, the clearinghouse or payer will include a rejection reason that can help you identify the problem. To view the rejection reason:
- Open the claim that was rejected.
- Click the History tab.
- To the right of the "rejected" message and then click the details icon
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Correct and Resubmit the Claim
Once you know why a claim was rejected, you can make corrections to the claim and resubmit it.
- Open the claim you want to correct.
- Make corrections to the claim's information:
- For any information that appears on the daily note (such as billing codes), return it to the therapist so they can update the document.
- 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.
- For any other fields, make a correction directly on the claim form.
NOTE: Do not refresh! If you refresh a claim after making a correction directly on the claim form, you will lose those changes when the claim pulls information from each field's source.
- In the lower right, click Send To Payer button to resubmit the claim.