No Void Option for a Submitted Claim

When dealing with a rejected claim, it's essential to follow the correct procedure to ensure the payment is collected efficiently. If a claim is rejected, you must request that your patient pay the full amount and then ask them to submit the claim directly to their insurer. This involves editing the claim to make it payable to the Patient, thereby transferring the full balance to them.

Claims Payable to Insurer Member, Patient, or Adjudicator Guarantor

In scenarios where a claim is payable to the insured member, Patient, or adjudicator guarantor, the entire balance is allocated to the Patient, irrespective of the Explanation of Benefits (EOB). Once the Patient pays the invoice, it's crucial to update the EOB status to "paid."

Important Note: Resubmission of rejected claims isn't permissible. Direct contact with the insurer can provide the reasons for rejection, or alternatively, the Patient can submit the claim to their insurer themselves.