Resetting, Editing and Resubmitting a Medicare Claim

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Resetting a failed or rejected Medicare claim allows you to resubmit it through Halaxy after you have corrected any errors in the claim.

Resetting a claim typically happens automatically, but you may be required to manually reset or edit a Medicare claim that you have already submitted if you have called Medicare to manually update a claim and you now need the new amount or status to display in Halaxy.

Manually setting a claim to a Cancelled or Failed status also allows you to edit the claim details and resubmit the claim:

Invoice_ResetRebateClaim.gif

Image: Manually setting a Medicare claim to Rejected/failed status (expand image)

You can reset or edit a Medicare claim by following the steps below:

  1. Click the blue link in the Status column on the invoice:

    Invoice_RebateStatus.png
  2. The Online Claim History pop-up appears. To reset the claim for resubmission, click the Reset icon to automatically reset the claim. If you need to manually edit the status of the claim or change the amount provided by Medicare, click the Edit (pencil) icon to manually set the claim status and proceed to step 3.

    Invoice_RebateStatusHistory.png
  3. In the pop-up, change the amount paid and reason status as desired. If you are setting the status to a rejected or failed status so you can resubmit the claim, ensure the Amount Paid From Funding field and the Amount Paid From Medicare field are set to $0.00:

    Invoice_RebateStatusReason.png
  4. Click Save.

RESULT: The invoice will be updated to show the new amount and status. If the claim was set to a Cancelled or Failed status, it can now be reprocessed.

Tip

You can "unreset" a claim by following the above process and clicking the Revert icon.

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