Please keep in mind that when a claim is denied, but it previously went through the Accepted by Payer status, the payer has already assigned a reference code or number (Payer Claim Number), which can be viewed in the claim history.
Once the claim has this number assigned by the payer, you must edit the claim, make the necessary corrections, and submit it again.
On the other hand, if a claim never went through the Accepted by Payer status, did not receive a Payer Claim Number, and was manually placed in Denied status, the process should be completed as follows:
- Access the payer portal and obtain the corresponding Payer Claim Number.
- Edit and correct the claim.
- Change the claim status to Accepted by Payer.
- Add the obtained Payer Claim Number.
- Change the claim status back to Denied.
- Submit the claim again to the payer.
After completing these steps, the claim will be properly resubmitted to the payer.