We are currently updating the OP Help Center content for the release of OP 14.19 or "OP 19". OP 19 is a member of the certified OP 14 family of products (official version is 14.19.1), which you may see in your software (such as in Help > About) and in the Help Center tabs labeled 14.19. You may also notice that the version number in content and videos may not match the version of your software, and some procedural content may not match the workflow in your software. We appreciate your patience and understanding as we make these enhancements.

Change Insurance on Individual Transactions (Daysheeted Claims)

Version 14.19
Path: Clinical, Billing, or Practice Management tab > Patient Chart button

Overview

If a daysheeted claim was sent to an incorrect payer, the insurance on the claim can easily be changed for submission to the correct payer.

Changing Insurance (Daysheeted Claims)

  1. Navigate to the patient's chart using the path above. 
  2. Click Insurance and inactivate any invalid insurance. 
  3. Enter a new insurance record, if necessary.
  4. Click Claims in the Window Navigation Panel.
  5. Select the claim whose payer needs to be changed.
  6. Click the Change Payer buttonThe Change Insurance on Individual Transactions window opens.
  7. Complete Steps 1-3 in the Change Transactions on Individual Transactions window:

  1. Choose transaction(s) to resubmit to a different insurance carrier. If a claim has multiple claim lines, hold down the CTRL key on your keyboard and select all transactions for the claim.
  2. Click to choose the new Primary Insurance carrier for the selected transactions.
  3. Click to choose the new Secondary Insurance carrier for selected transactions (if applicable). If there is no secondary, select the Omit checkbox.
  1. Click Requeue as Primary or Requeue as Secondary, depending on where the claim needs to be transmitted. If the claim is not to be sent to the Transmit Queue, click Apply Only.
  2. Close the Change Insurance on Individual Transactions window.
Version 14.10
Path: Smart Toolbar > Account

Overview

At times, there will be instances when a claim goes out the door to the wrong insurance, and needs to be resent to the most accurate and up to date insurance for a patient. Please follow the following steps to change insurance on a claim that has been daysheeted.

Changing Insurance (Daysheeted Claims)

  1. Open the Patient Account on the Smart Toolbar.

  1. Click on Insurance tab.
  2. Inactivate any invalid insurance and Insert a New Insurance Record for the most up to date insurance for a patient.
  3. Once you update to the newest insurance click on the Claims tab.
  4. Then select the Change Payer button.
  5. The Change Insurance on Individual Transactions window will open.
    Follow the Steps #a-#c.
  1. Choose transaction(s) to resubmit to a different insurance carrier by holding down your CTRL key on your keyboard and select transactions with your mouse to highlight.
  2. Choose new Primary Insurance carrier for selected transactions.
  3. Choose new Secondary Insurance carrier for selected transactions (optional), if no other insurance Check the box for Omit.
  1. Then select to the right, Requeue to Primary if sending back out the door electronically, if Dropping to CMS-1500 form, click Apply Only.
  2. Click on the Red X to close the Change Insurance on Individual Transactions window.

Click for the next section: Processing an Insurance Retraction or TakeBack or Recoupment.