Reprint vs. Resubmit

In SOS G5, the term reprint refers to the process of outputting an exact duplicate of a generated claim. For example, perhaps a claim was mangled by your printer, or the patient requests a copy of the claim that you sent. The emphasis here is that the reprinted claim will be an exact duplicate of the original. The specific steps are detailed in the Reprinting a Claim section of this article below.

Let us say, for example, that you file a claim and it is rejected by the payer because the procedure being billed is not consistent with the diagnosis indicated on the claim. In that case, you would consult with the provider and perhaps change either the diagnosis or procedure. After making the desired change, you can simply generate a new claim for the particular patient and service date, using the normal procedure, but checking the claim creation option to Include previously billed items.

In some instances, however, your payer may instruct you to do a formal resubmission of the claim. That procedure is a bit different from the normal claim generation, and is described in the Resubmitting a Claim section of this article below.

Reprinting a Claim

To output another copy of a previously generated claim, you have a choice of two procedures:

Procedure One (quick & easy) – Output a single page from the preview of the entire batch.

1. Select Claims > Output Claims(s)… in the SOS Navigation Bar.
2. Find the claim batch in which your original claim was created. (Double-click the claim batch to view the specific claims in that batch to confirm that the desired claim is in the batch.)
3. Use the Reprint Claims button to open the preview and locate the claim you actually want to reprint. Note the page number in the bottom margin of the preview window.
   
4. Click the Printer with Question Mark button in the toolbar. That button will provide you with printer options, including the option to specify the page(s) you want to print.
   

Procedure Two – Clear billed dates for the charges on the desired claim, then create a new claim.

1. Select Claims > Output Claims(s)… in the SOS Navigation Bar.
2. Find the claim batch in which your original claim was created. (Double-click the claim batch to view the specific claims in that batch to confirm that the desired claim is in the batch.)
3. Highlight the claim you want to reprint and click the Clear Billed Dates button to reset all the charges on that one claim. If you want to reset more than one claim in the list, tag those you want to select by holding down the <CTRL> key and clicking each one. To tag all the claims, use the Tag All (yellow map pins) button.

   It is also possible to clear the billed dates on only some of the charges on a claim. To drill down to the specific charge line on a claim, highlight the claim and click the first button on the toolbar instead.
   

4. Go back to the Navigation Bar and select Claims > Create A New Claim…
5. Make sure you uncheck the Include Previously Billed Items option, then carefully specify the patient and date range of the services covered on the claim you want to reprint.

Resubmitting a Claim

To do a formal claim re-submission, you will need:

• The SOS identifier of the original claim. This value is found on each charge included on the claim you are trying to resubmit, so open any of those charges and double-click the charge split for the appropriate insurance payer. You will see the claim number in the lower right corner of the top panel, as shown below. Click in the field, press <CTRL-A> to highlight the value, then <CTRL-C> to copy it to your clipboard so you can paste it in a later step.
• The appropriate resubmission code. For professional claims, the code is usually “7” if you want the new claim to replace the original one, or “8” if you just want to void the previously submitted claim altogether. Institutional resubmission codes are different. Check with your payer if you are not sure of the appropriate code for your situation.
• The payer’s reference number for the original claim. You can find that value on the EOB or from your payer.

Armed with the above, start as you would for a new claim (Claims > Create a New Claim…).

1. At the top of the Create Claims screen, check the box “Create A Claim For Resubmission From A Previous Claim“.
   
2. As soon as you check that option, the normal selection fields will disappear and instead you will see a set of four fields to collect the resubmission data detailed above. Paste your SOS claim number in the first field. The resubmission code goes below that, and the payer’s number for your original claim goes to the right of the code.
   
3. Finally, click the Create Claims button just below those fields.