Denied claims can be corrected and re-submitted using Kalix.
Contents of this article:
To re-submit a corrected electronic claim denied by the insurance company or Office Ally, previously created in Kalix, please follow the steps below:
Step 1: Locate the Created Bill
The first step is to locate the previously created claim (or bill) in Kalix. The bill can be found:
Against the particular client's file
On your Bills list
In the batch used to send the claim to Office Ally
Against the client
1) Locate your client using the client search functionality.
2) Open their Cover Page and scroll down to the Billing section.
3) Click on the applicable bill to select.
1) Hover on Billing on the top menu bar and navigate to the Bills page.
2) Locate the bill and click to open.
Via the Batch
1) Hover over Billing on the top menu bar and select Batches
2) Make sure you have the correct time filter and status filter selected
3) Click on the batch containing the bill.
4) Every bill within the batch will be listed. Select the specific bill to edit.
Step 2: Edit the Bill
Once the bill is opened, click on Details (as shown below) to view and edit.
At the bottom of each bill section, several options exist for modifying the contained details.
Edit Linked Records
Clicking on this icon will take you back to the Quick Step-up page, where you can modify the bill's linked records.
Edit (Pencil icon)
The pencil icon (only supported for Client, Referring Provider, ICD-10 Diagnosis Codes & Bill Items) allows you to change or correct the entered information on a specific bill section.
After clicking on the pencil icon, a pop-up window will appear. Make your changes and then click Update.
Note: Changes are made to the bill's information only. They do not flow back to the pulled record.
Edit permits you to modify the selected options on a specific bill section, e.g., select a different rendering provider. After clicking on the edit icon, a pop-up window will appear. Make your changes and then click Update.
Use the Refresh icon to update (or reload) a bill section after changes are made to the page from which its info was auto-filled.
Using the Rendering Provider section as an example, if you update the My Details page (for example, change the Other ID) by clicking Refresh, this section will get the most up-to-date details (i.e., the corrected Other ID).
Fixing the Source of Errors
Instead of just fixing the errors on the specific bill, you can edit (and correct) its source. To do this, select the button at the bottom left of the Edit window (as shown above), e.g., Edit My Details. By clicking on this button, Kalix will take you to the page where the info was initially pulled from.
If you edit the info source instead, e.g., the My Details page, and then navigate back to the bill (just press back on the browser), use the Refresh feature to update the bill.
Resubmission Code and Original Reference Number
If the insurance company (not just Office Ally) rejects the claim, you are required to use a resubmission code and reference number. In that case, the resubmission code can enter them into the appropriate fields under the Miscellaneous section.
4) Once the bill is corrected, scroll down to the bottom of the page and click Save.
Step 3: Resubmit the Claim
Add Claim to a New Batch
1) After clicking save, Kalix will close to the Payments page. If you'd like to add this updated claim to your next batch, please change the status to Ready to batch (as shown below.)
2) Create a Batch as usual. The updated claim will be included in your list of ready-to-batch bills.
Resubmit Existing Batch
Alternatively, if you open the batch that contains the failed claim/s, click on the "Resend Rejected Claims" to resubmit all rejected claims to Office Ally.