Problem Statement

Claim edits create manual rework before a claim can go out the door, and edits left unresolved either delay submission or, if missed, produce avoidable denials that erode the clean claim rate and push out cash collection. When a claim needs a corrected Internal Control Number, it can't simply be resent; it has to be rebilled as a replacement, which means flagging it as a replacement claim, applying the corrected ICN, routing it for submission, and documenting the activity. Done by hand across a list of invoices, this multi-step correction is slow and easy to get wrong.

Automation Solution

This automation works a list of invoices needing a corrected ICN, sets claim frequency 7 to initiate a replacement and enters the corrected ICN in Athena, routes the claim to the electronic claim queue, marks it worked, and records activity notes.