Claim Rejected Due to Policy Holder's Name

If the claim is rejected due to the policy holder's name, verify and update the policy holder information as needed.

Instructions

The steps required to correct the error is dependent upon the information that is currently in the Policy Holder field and the information that should be in the field.

• Access Patients > search for and open the patient > Insurance > open the insurance company.

If the Policy Holder field displays the patient's name and it should be a family member or contact, complete the following.

1. Click the search icon in the Policy Holder field.
2. In the Coverage Selection modal, select either Contacts or Family Members to display names.
3. Select the appropriate name from the Policy Holder grid.
4. Select the appropriate insurance company from the Policies grid.
5. Click 'Select.'
6. Click 'Save.'

If the Policy Holder field displays a family member or contact's name and it should display the patient's name, complete the following.

1. The insurance information cannot be edited. Click 'Deactivate.'
2. Return to the Insurance screen.
3. Click the + icon.
4. Complete all required fields and ensure to use the patient's name as the policy holder.
5. Click 'Save.'
6. The rejected claim is assigned to the original invoice that has the deactivated insurance company. There are two options available to create a new invoice:
   • Option One - Transfer Items
     1. Open the original invoice.
     2. Click 'Transfer Items.'
     3. In the Transfer Items modal, select a Transfer Reason.
     4. Click the checkbox for "Include All Items in Transfer."
     5. In the Transfer To field, click 'Insurance.'
     6. Click the radio button for New Invoice.
     7. Click 'Save.'
   • Option Two - Void Invoice
     1. Open the invoice.
     2. Click the edit icon.
     3. Ensure Void displays and click the checkmark icon. Note: If there is a patient invoice linked to the insurance invoice you are voiding, an error message displays and provides the patient's invoice number.
        1. Make a note of the patient's invoice number.
        2. Close the insurance invoice.
        3. Access the patient's invoice and change the status to Active. 
        4. Access the insurance invoice and void.
     4. Create a new invoice using the newly added insurance information.