Resubmitting a rejected secondary claim

A secondary claim can come back rejected — a wrong member number, a missing Medicare type code, or a payer that wants the claim a different way. When that happens you don't start over: Pabau reopens the secondary on the same claim so you can correct the details and send it again, and it goes to the payer as the same claim rather than a duplicate.

Spotting a rejected secondary

There are two places a rejected secondary shows up:

• On the claim itself, the settlement bar shows the secondary result next to the primary — for example Secondary: Rejected, with the payer's reason.
• On the claims list (Money → Insurance claims), use the Secondary rejected filter to pull up every claim whose secondary needs attention in one place, so nothing sits forgotten behind a paid primary.

Resubmitting it

Open the claim. Because the secondary was rejected rather than paid, the settlement bar offers Resubmit secondary claim (in place of the usual Create secondary claim). Then:

• Click Resubmit secondary claim.
• Correct whatever the rejection was about — the secondary payer, the member/policy number, the group number, or the Medicare (MSP) type code if the secondary is Medicare.
• Click Submit secondary claim. Pabau updates the existing secondary claim at the clearinghouse rather than creating a second one, so the payer sees one corrected claim, not a duplicate.

Once it's accepted

After a successful resubmission the secondary's status moves off Rejected on the settlement bar, and it drops out of the Secondary rejected filter on the claims list. From there it tracks to payment like any other secondary claim.