![]() The payer may require the Submit Reason to appear in other areas of the claim.Enter the Payer Doc Ctrl # (if the field is not grayed out).Contact the payer directly with any questions about correct claim submissions. Select the correct Submit Reason code. The Submit Reason code depends on the payer’s requirements.Click the arrows next to Miscellaneous to expand.Look for and double-click on the encounter that needs correcting.Click Encounters > Track Claim Status.For example, Medicare will not accept any Claim Submission Reason Code other than “1 –Original.” Do not change the Submit Reason unless you are certain the payer needs it changed. Note: The submit reason code depends on the payer's requirements. If the claim needs to be resubmitted as a corrected claim (per payer request), follow the instructions below to enter the submit reason on the encounter:.If the initial claim is still processing, this rejection will not affect the status of the initial submission.Determine if the claim needs to be corrected and (if so) how to properly resubmit. If the exact claim was submitted within 48 hours of the previous claim, contact the payer to verify the status of the previous claim submission.Resolution steps will vary depending on the cause: The submission reason code and additional information was not included on the corrected claim that was resubmitted.The exact claim was resubmitted within 48 hours of the last submission. ![]() This rejection message indicates that the payer has received the exact claim or service before. The actual rejection in their system is: DUPLICATE OF A PREVIOUSLY PROCESSED CLAIM/LINE This rejection message and solution is specifically for claims billed to Humana. ![]() ACKNOWLEDGEMENT/RETURNED AS UNPROCESSABLE CLAIM THE CLAIM/ENCOUNTER HAS BEEN REJECTED AND H
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