Reprocessing Encounters Due to Changes in Patient Insurance

When a patient changes their insurance coverage, you must reprocess any encounters billed to the former insurance payer, and submit new claims to the patient's new insurance payer. DrCloudEHR facilitates this process by reopening the original encounters and applying any billing rules for the new insurance payer before you submit the claims.

The steps you follow to reprocess encounters are:

• Change the status on each original claim to void, and then submit the claim to the patient's original insurance payer. 
• Reprocess the encounter. DrCloudEHR resets the encounter, applies any billing rules that exist for the new insurance payer, and moves the encounter to the Billing Manager.
• Submit a new claim to the patient's new insurance payer.

A message indicating that the patient's insurance has changed and that any pending encounters need to be reprocessed is displayed on the Reminders tab in your Inbox. 

This topic contains the following sections:

Void the Original Claim

When you reprocess an encounter, you must use the Claims Manager to void the original claim filed against the patient's previous insurance payer. 

1. Click the Billing tab.
2. Click Claims Manager in the left navigation bar.
3. Search for the claim, and then click the claim number in the results to open the claim.
   
   
   
   
4. In the HCFA form, set the Submission Code property to Voided/Cancelled Claim.
   
   
   
   
5. Click the Submit button at the bottom of the page to submit the voided claim to the patient's previous insurance payer.

Reprocess the Encounter

Reopening the original encounter and applying any billing rules for the new insurance payer before you resubmit the claim.

1. Click the Billing tab.
2. Click Reprocess Encounters in the left navigation bar.

3. Enter your search criteria, and then click Search. 
   Select Needs Reprocessing from the Encounter Reprocess Status menu to find encounters that need to be reprocessed.

4. Select the checkbox for each encounter that needs to be reprocessed.
5. Click Reprocess Encounters. 
   
   
   
   
6. Click Go To Billing Manager and submit a new encounter claim to the patient's new insurance payer.