The Comeback: How to Resubmit Your Insurance Claim and Win

Introduction

Resubmitting a claim is different from a formal appeal. Resubmission is typically used when the original claim had missing information or technical errors. Think of it as a "do-over" to get the facts straight.

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Step 1: The "Clean Claim" Audit

Before hitting send again, perform a manual audit of your claim form. Check for:

• Patient Details: Do the name and DOB match the insurance card exactly?
• Provider Info: Is the NPI (National Provider Identifier) correct?
• ICD-10 Codes: Are the diagnosis codes specific enough?

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Step 2: Attachment Protocol

Often, claims are rejected because the insurer "didn't receive" the attachments. When resubmitting:

• Use a Cover Sheet listing every document included.
• Number your pages (e.g., "Page 1 of 10").
• If filing digitally, ensure file names are clear (e.g., "Surgery_Report_Claim_123.pdf").

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Step 3: Clarify the "New" Information

When you resubmit, include a brief note explaining what has changed. Example: "This claim is being resubmitted with the corrected billing code (CPT 99214) as requested in the denial notification dated Jan 10th."

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Conclusion

A "Clean Claim" is a fast claim. By taking ten extra minutes to audit your resubmission, you can avoid months of back-and-forth frustration.