eClaims - Using the Rebuild Button

The Rebuild Button is available in all status bins of the eClaims Ability. It will only light up to be clicked if one or more claims are highlighted within the current bin.

When the Rebuild Button is pressed, all selected claims will update their information with any changes that were made in MacPractice.

For example: If the patient's birthdate was incorrect in the claim, the user can go to the patient's record in the Patient's Ability and change the patient's birthdate in the record. From there, the user can go back to the eClaims Ability, highlight claims for this patient, and press the Rebuild Button. The patient's birthdate will then update within the claim details to match the new birthdate value that was entered in the patient's record.

When to Use the Rebuild Button

The Rebuild button is used to take information that has changed in MacPractice and apply it to the claim, overwriting the existing information that has been changed in MacPractice in relation to this claim.

There are a few cases when the Rebuild button will not work for the previously mentioned purposes and the claim must be recreated in the patient ledger.The Rebuild button will not recreate the claim as desired under the following circumstances:

New insurance

In a case where the claim was created using the wrong insurance reference, a new insurance reference is usually chosen for the patient and the previous insurance is either deactivated or archived. If a new insurance reference is selected for the patient, existing claims will not update with a rebuild. In this case a new claim will have to be created entirely.

If the previous insurance has been deactivated or archived in MacPractice, any claims created on this insurance will continue to retain all information related to the previous insurance. Information such as Payer ID, Payer Name, etc. will not change by rebuilding any existing claims.

It should not be necessary under normal circumstances to recreate the charges in the ledger in this situation. Only the claim would need to be recreated.

If the insurance reference didn't actually change to a different insurance reference and the change was only made in the existing insurance reference, any information that was changed such as payer ID, insurance address, insurance name, etc., in the existing insurance reference will update with a rebuild.

Prior Authorization Numbers

In a case where a prior authorization number needs to be added to or removed from the claim, a new claim will need to be created. The prior authorization number is selected or omitted in the claim creation window at the time of claim creation. Changing the prior authorization in the ledger incident and rebuilding the claim will not have any effect on the claim.

Accept Assignment

Though this gets set within MacPractice, the final determination for Accept Assignment is made at the time of claim creation. Changing this in the insurance reference, or anywhere else in MacPractice, will not affect the rebuilding of the claim. The eClaim will maintain the originally selected status on rebuild. To change the Accept Assignment status, a claim needs to be recreated.

Different Template

Some offices use multiple templates for any number of reasons. Each template will have different default and override information set in it that will impose itself on a claim. There is no way that using Rebuild can correct this. In an event where a claim was created on the wrong template, there is no way other than recreating the claim on the appropriate template to correct this situation.

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