PMP Manual Manitoba - Jul. 2014 | Page 68

PATIENT MANAGEMENT PROGRAM Handling On Screen Rejections during Reconciliation If MH has rejected any claims a screen will appear entitled 'Handle Rejections'. Decisions will be required regarding each rejection. The rejection code you choose will determine the action that is taken. Three options are available to deal with the rejections: 1. Transfer to Patient 2. Transfer to Patient & Write Off 3. Rebill the Claim You may either press the numbers 1, 2, 3 on your keyboard or click the box below the title selections on the top right of the screen. For example: if the code is 01 - MH Number not valid, you will choose. # 3. Rebill if you are able to correct the claim. Note: Rebilled claims will not be resubmitted to Manitoba Health automatically. Follow the procedure below to resubmit the claim. When in doubt choose Rebill. You can always re-submit or pay the claim once you understand the reason for the rejection. A complete list of Manitoba Health Disposal Codes is available in the Appendix at the back of this workbook. A check mark will appear in the box where you have clicked or pressed. When all rejections have been handled, click Finish. Click View MH Payment Rejection Journal to print the report. This report will be stored in Documents for Printing under the Report menu and can be viewed or printed at a later time. The Payment Rejection Journal is named ‘MH_ PRJ’ followed by the creation date. Click Continue. Rebilling Rejected Claims After selecting the Rebill button claims will not be automatically submitted to MH. Invalid or missing information exists within the claim and must be resolved before the claim is submitted again. After the incorrect/missing information has been fixed in the patient file go to the Account Activity tab and select the rejected claim. Click the Pending <-> Billed button. This will mark the claim back to pending which will allow it to be picked up during the submission to MH. Continue for all rejected claims. 68 | Manitoba Health Services Commission