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. From the Clinical, Billing or Practice Management tab, click the Patient Chart button
  2. Click Insurance and inactivate any invalid insurance
  3. Enter a new Insurance Record, if necessary
  4. In the Window Navigation Panel, click Claims 
  5. Select the Claim whose payer needs to be changed.
  6. Click the Change Payer button
  7. The Change Insurance on Individual Transactions window is displayed
  8. In the Change Transactions on Individual Transactions window, complete steps 1-3

  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 select the new Primary Insurance carrier for the selected Transactions
  3. Click to select the new Secondary Insurance carrier for selected Transactions (if applicable). If there is no secondary, select the Omit checkbox.
  1. Click the Requeue as Primary button or the Requeue as Secondary button, 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 are instances when a claim goes 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. On the Smart Toolbar, open the Patient Account 

  1. Click on the 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 the Claims tab
  4. Select the Change Payer button
  5. The Change Insurance on Individual Transactions window is displayed 
    Follow the Steps #a-#c.
  1. Select Transaction(s) to resubmit to a different insurance carrier by holding down your CTRL key on your keyboard and selecting Transactions
  2. Select a new Primary Insurance carrier for selected Transactions.
  3. Select a new Secondary Insurance carrier for selected Transactions (optional), if there is no other insurance, select the checkbox for Omit.
  1. Click the Requeue to Primary button if you are sending it back out electronically, if Dropping to CMS-1500 form, click Apply Only.
  2. Click the Red X to close the window.

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