Correcting, resubmitting, and reverting claims

In the left sidebar, click Claims to work claims across the practice. To work one patient's claims, in the left sidebar, click Patients, 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. The claim actions area now sits in the updated panel layout.

Use Claim actions (1) in the claim actions area for actions such as correcting, resubmitting, billing secondary, or collecting copay when they are available. Use Alerts (2) to review validation issues, payer messages, or other claim warnings. Use History (3) to open the activity timeline and saved snapshots for the claim.

How do I correct a denied claim?

In the left sidebar, click Claims, then select the denied claim when a payer denied it and you need to send a corrected replacement. Ona creates a new draft for the correction and keeps the original denial closed as superseded. If you opened the claims workspace from an archived patient's chart, you can view the claim, but correction actions are blocked.

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 (1) and includes View original (2) so you can return to the denial. The original denial shows Superseded by a correction (3) and, when available, Open correction.

How do I resubmit a claim?

In the left sidebar, click Claims, then select the claim to send again when the resubmission action is available for that claim. If the payer requires CMS-1500 Box 22, use Resubmission code (22) and Payer's claim number / ICN (22) before sending. Rejected claims can default to 1 — New claim (Original Medicare) when that applies. If you opened the claims workspace from an archived patient's chart, you can view the claim, but resubmission actions are blocked. The draft editor also includes Attachments for unsent claims, so you can manage supporting documents there before resubmitting; those attachments go out again with the next electronic submission.

Use Validation alerts (1) to review blocking errors, Enter remittance (2) when Box 22 applies, and Fix & resubmit (3) to send the claim again.

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 Payer's claim number / ICN (22).
6. Use Fix & resubmit in the pinned footer 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?

In the left sidebar, click Claims, then select the claim when you need to roll it back to a saved version. Claim history can include draft edits, submissions, resubmissions, provider changes, chart syncs, payer updates, card charge scheduled events and reversions. If you opened the claims workspace from an archived patient's chart, you can view the claim history, but revert actions are blocked.

Use the History tab (1) to open claim activity, the Timeline entries (2) to find the saved version, and View snapshot (3) to inspect it before reverting.

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, then select the claim and 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 the History tab (1) to open the activity list, the Actor and time (2) to see who made the change and when, and View snapshot (3) when a saved version is available.

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

What can't I do here?

In the claims queue, 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.
• When the claims workspace is opened from an archived patient's chart, you can view the claim, but correction, resubmission and revert actions are blocked.

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?

Open the corrected claim and select View original in the correction banner.

How do I open the replacement from the denied claim?

Open the denied claim. If a replacement is linked, the superseded note shows Open correction.

Where do Box 22 resubmission details go?

On the claim, use Resubmission code (22) and Payer's claim number / ICN (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.