Takebacks Process

To perform a takeback:

1. Go to Financials > Claims Management and select the Service Line from the dropdown.

2. Enter the date range that you need to send back.

3. Search for and select the Client, and if applicable, select the Payor. Click Search.

4. Locate and select the checkboxes of the claim(s). Click the Move Claims To Workbench button. If you are only sending specific Service Codes, click the Columns button and select Service Code.

5. Click into the Claims Workbench tab at the top of the page. Use the filters to narrow the claims display.

6. In the Actions column, click on the Ellipsis and select Claim Notes. Add a note explaining why you are doing the takeback.

7. Select the radio button of the claim and click the Void button. The claim will go through validation and go to the Ready card.

8. Repeat steps 6-7 for each claim.

9. Go back to the Process Claims tab and click on the Ready card.

10. Select the claim(s) checkbox and click the Send to the Payor button.

11. Once you send the claims to the Payor you can inform the case worker that the takeback has been submitted. There is no need to wait for the remit to post.

When the remit posts, the claims will go to the Void card. If you can reprocess them, go to the Void card and move the claim(s) to the Claims Workbench to resubmit them. Ensure that the necessary edits have been completed in the Service Agreement in the Client Profile before resubmitting the claims.

The claims will go to the Ready card so that you can send them the Payor.