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Duplicate of a Previously Processed Claim/Line

Updated: 05/19/2021
Views: 11391

Rejection Message

DUPLICATE OF A PREVIOUSLY PROCESSED CLAIM/LINE

Rejection Details

This rejection message indicates the payer has received the exact claim or service before. This rejection has two possible causes:

  • The exact claim was resubmitted within 48 hours of the last submission.
  • The resubmitted corrected claim did not include additional information (e.g., submit reason/claim frequency code) per payer requirements. 

Resolution

Resolution steps vary depending on the cause:

  • If the exact claim was resubmitted within 48 hours of the last submission (as shown in the image example), contact the payer to verify the status of the previous claim submission and any necessary next steps. 
    Note: This rejection does not affect the status of the previous claim submission if it is still processing. 
EditClaim_DuplicateRejection.png
  • If a corrected claim needs to be resubmitted with a specific claim frequency code, follow the instructions below to enter the Submit Reason in the encounter.
    Note: When unsure, contact the payer and verify the required information to prevent further claim rejections and processing delays. For example, Medicare does not accept any claim frequency code other than 1 to indicate the claim is an original claim. 
    1. Click Encounters > Track Claim Status. The Find Claim window opens.
    2. Find and double click the claim that needs correcting. The Edit Claim window opens.
    3. Double click on the Encounter ID number. The Edit Encounter window opens.
    4. Click the double arrow to expand the Miscellaneous section.
    5. Click to select the payer required Submit Reason code.
      • If Submit Reason code 67, or is selected, enter the associated Payer Doc Ctrl # (Payer Document/Claim Control Number) as required by the payer for claim processing.
      • If the payer requires the Submit Reason to appear in other areas of the claim, follow the below steps.
        • For paper claims, enter the information as follows:
          • Claim Code (Box 10d): Enter up to 19 characters to report appropriate claim codes to identify additional information about the claim.
          • Add'l Claim Info (Box 19): Enter up to 71 characters to identify additional information about the claim.
        • For e-claims, click the E-Claim Note Type drop-down arrow and select Additional Information. Then, enter the required information as an E-Claim Note.
    6. Click Save & Rebill. Then, resubmit all affected claims once all corrective actions are complete.
EditEncounter_Misc_SubmitReason.png

 

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