Editing a claim depends on where the claim is in the claims process:
- Single claim from approved encounter, not yet submitted to clearinghouse or mailed to payer
Click Encounters > Track Claim Status. Locate and open the claim. Make changes to the claim as necessary. Note that if any changes need to be made to the patient or case record associated with the claim, you can double-click on the hyperlink in either field to open the corresponding record. Once you edit and save the record, you will be automatically returned to the open claim. Be sure to save the claim once all changes have been made.
- Multiple claims from a single, approved encounter, not yet submitted to clearinghouse or mailed to payer
The easiest and safest way to correct multiple claims generated by a single encounter is to access the original encounter record and unapprove the encounter; this deletes all claims associated with it. Once you make the necessary changes to the encounter or any other record associated with the encounter, you will then re-approve it. This will create a whole new set of claims to replace the claims that were just deleted. To open an encounter record from any open claim, double-click on the hyperlink in the Encounter field of the claim.
- Electronically submitted claims rejected by clearinghouse, payer or Kareo PM
The best way to manage rejected claims is through the clearinghouse reports. Click Encounters > Clearinghouse Reports. The Claim Processing tab lists all unreviewed daily claim reports, internal validation reports and payer responses. Within these reports, you can easily identify the claims that have been rejected due to claim errors. Each rejected claim provides an explanation for the rejection and a link to the original encounter record. For more information on correcting rejected claims, see section Claim Rejections.