Self Service Reopenings (Part B) - Portal Guide
Self Service Reopenings (Part B)
A self service reopening or recoupment request is submitted by performing a claim status inquiry first. The Self Service Reopening link is located under Related Inquiries once the claim has been retrieved.
Step 1: Selection
The first question asked will determine if a Self Service Reopening or a Recoupment Request will be completed.
"Is this an overpayment refund?"
- If Yes, continue onto the Part B Recoupment Request instructions
- If No, continue with the following steps
Choose one of the following:
- Reprocess Claim - Provides a "pop-up" box asking if you are sure you want to reprocess the claim. Choose Cancel or Submit.
Modify Claim - Choose Adjustment Type(s):
- Billed Amount
- Billed in Error
- Date of Service
- MSP Type
- Place of Service
- Procedure Code
- Referring Provider
- Rendering Provider
If Billed in Error is selected, a Billed in Error Reason Code needs to be selected
- Billing Error
- Code Change
- Corrected Date of Service
- Not our Patient
- Services not Rendered
- Modifier Add/Remove
- Insufficient Documentation
- Patient in an HMO
- Veterans Administration Paid
- Medical Necessity
- Patient in Skilled Nursing Facility
Choose claim line(s) the adjustment will apply to
- Select Billed in Error or Reprocess if appropriate. Both cannot be selected.
- Choose Next
Step 2: Corrections
All fields that are able to be adjusted are opened to make corrections. Once the correction has been made, choose Next.
Step 3: Submission
Step 3 provides the user with updated claim lines based on the changes selected. Review the changes, select the checkbox to verify the changes are accurate and choose Confirm Changes.
Note: Error messages will be displayed if the claim cannot be modified with further instructions.
Step 4: Confirmation
Step 4 provides the Confirmation Number of the request. This indicates the reopening was submitted and will be processed.
Last Updated Fri, 21 Feb 2020 07:47:29 +0000