Correcting, resubmitting, and reverting claims

In the left sidebar, click Claims to work claims across the practice. To work one patient's claims, click Patients in the left sidebar, click the patient's name, then click Claims in the patient chart sidebar. Selecting a claim opens its detail panel, where claim actions, alerts, payer messages, payment details, CMS-1500 details such as claim providers and NDC service-line information, and history appear together.

How do I correct a denied claim?

Use Claims when a payer denied a claim and you need to send a corrected replacement. Ona creates a new draft for the correction and keeps the original denial closed as superseded.

1. In the left sidebar, click Claims.
2. Select the denied claim.
3. Review the payer messages, alerts and payment details to understand what needs to change.
4. Select Correct claim.
5. In the replacement draft, fix the information the payer denied.
6. Submit the replacement when it is ready.

The replacement draft shows Correction of a denied claim and includes View original so you can return to the denial. The original denial shows Superseded by a correction and, when available, Open correction.

How do I resubmit a claim?

Use Claims to send a claim again when the resubmission action is available for that claim. If the payer requires CMS-1500 Box 22, add the resubmission details before sending.

1. In the left sidebar, click Claims.
2. Select the claim you need to send again.
3. Review any validation alerts and fix blocking errors before you send.
4. If Box 22 applies, open the draft editor.
5. In Additional claim info, update Resubmission code (22) and Original ref. (22).
6. Use the resubmission action when the claim is ready.

Ona sends the claim again and adds Resubmitted to payer to the claim history.

How do I revert a claim to an earlier version?

Use History on a claim in Claims when you need to roll the claim back to a saved version. Claim history can include draft edits, submissions, resubmissions, provider changes, chart syncs, payer updates and reversions.

1. In the left sidebar, click Claims.
2. Select the claim.
3. Open History.
4. Select View snapshot on the version you want to inspect.
5. Review the snapshot to make sure it is the version you want.
6. Use the revert action from the snapshot.

The claim returns to that earlier version, and Reverted to earlier version appears in the history.

How do I use claim history while fixing a claim?

In the left sidebar, click Claims, select the claim, then open History to see what changed and who or what made the change. Activity entries can show the actor, relative time, outside reference information and, when a saved version is available, View snapshot.

Use snapshots before reverting so you can confirm the version you are restoring. Edits, submissions and payer responses also appear in the activity timeline.

What can't I do here?

In the left sidebar, click Claims. Access and actions are limited in these ways:

• Clinicians do not have the full operational claims queue unless they also hold an owner, admin or staff role.
• If insurance claims are not enabled for the organization, Claims is not available.
• You cannot submit a claim while it has blocking pre-submission validation errors.
• Once a denied claim is superseded by a correction, work continues on the replacement claim instead of the original denial.
• A correction is for a denied claim. Use resubmission only when the resubmission action is available for that claim.

Common questions

What happens to the original claim after I create a correction?

The original denial is closed as superseded. It stays in the record, and the replacement claim becomes the place where you fix and submit the corrected information.

How do I get back to the original denial from the corrected claim?

In the left sidebar, click Claims, select the corrected claim, and select View original in the correction banner.

How do I open the replacement from the denied claim?

In the left sidebar, click Claims, then select the denied claim. If a replacement is linked, the superseded note shows Open correction.

Where do Box 22 resubmission details go?

In the left sidebar, click Claims, select the claim, then open the claim draft and use Resubmission code (22) and Original ref. (22) in Additional claim info.

Why can't I correct or resubmit a claim?

The action may not be available for that claim's current state. The claim may also have blocking validation errors that need to be fixed before it can be sent.