ADP Resubmission Process
1a. Click here
to create a
plan
payment
record.
1b. Click here to
select an
existing plan
payment record.
1. The ‘bill another payor’ or resubmit capability is accessed through the Payment screen based on
the assumption that you would want to do this if you received an EOB which did not pay the
amount in full.
a. If payments are not being posted as part of your business process, simply create a zero
payment record for the payor plan which was billed.
b. If payments are being posted or if a zero plan payment record already exists, choose the
appropriate record by clicking ‘Profile’.
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ADP Resubmission Process
2a. Select the
desired plan
2c. Indicate a
zero Payment
Amount.
2b. Select the
Payment transaction
type.
3. Click here to go to the
Payment Application
Claim List.
2d. Click here
to create a
payment
record.
2. If needed, create a new zero payment record as illustrated above by selecting the appropriate
payor plan and clicking Save.
3. If you are in an existing payment record or after you have completed Step 2, click Apply
Payment to see the Payment Application Claim List.
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ADP Resubmission Process
4a. Search
for the
client of
interest.
4b. Click here
to see the
client’s claims
with a nonzero balance.
5. Click here
to select a
claim for
resubmission.
4. By default, the search will return all claims with a non-zero balance which have been billed to
this Payor Plan, i.e. all those with an outstanding balance or a credit balance. To limit the
number claims returned , search for the client of interest and click Go.
5. Identify the claim that you want to submit. Note that multiple encounters may be included on a
single claim.
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ADP Resubmission Process
6. Click
here to
Bill
Another
Payor.
6. Click Bill Another Payor. This is used to re-submit to the same payor (a resubmission) or bill to a
different payor when the previous billing was to the incorrect payor or bill to a
secondary/tertiary payor for COB coordination.
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ADP Resubmission Process
7a. ADP is
always
primary.
1.
7b. Select the
ADP group &
plan.
7d. Click here to
return to Payment
Application Claim List.
7c. Set the
status to Hold
to make these
easier to find
when
performing a
Claim Item
Search later.
7. For resubmissions to ADP, the information should be entered as above.
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ADP Resubmission Process
8a. Select
another
client OR
8b. Select
another
claim OR
8c. Finish and
go to the Claim
Item List.
8. If you are done, click Finish and go to Claim Item List to continue. Otherwise, select another
claim for the same client or re-query for a different client. In this scenario, we are going to
select another claim which includes multiple encounters.
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ADP Resubmission Process
9. Click
here to
Bill
Another
Payor.
9. This returns you to the Payment Application Claim Profile where you simply click Bill Another
Payor.
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ADP Resubmission Process
10. Click here
to remove an
encounter
which should
not be
resubmitted.
10. The header information should be completed as in Step 7. Since this claim included multiple
encounters, use the Remove action to remove any encounters that you do not want to
resubmit.
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ADP Resubmission Process
11. Click here save the
information & return to
Payment Application Claim List.
11. Once the list reflects the encounters from this claim which should be resubmitted, click Finish.
This will bring you back to Payment Application Claim List (Step 8).
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ADP Resubmission Process
11b. Select the
encounter
which is being
resubmitted.
11a. Search for
claim items
with a HOLD
status.
12. In this scenario, we are assuming that you were finished identifying all of the items which need
to be resubmitted and as directed in Step 8, have gone to the Claim Item List screen.
a. Search on Claim Items with a status of HOLD.
b. Click on the Profile action for each encounter which is to be resubmitted.
13a. Select
the Multiple
Service
Override and
Delay Reason.
13b. Click here to
save your changes.
14a. Click here to change
the status to Released.
14b. Click here to return
to the Claim Item List.
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ADP Resubmission Process
13. Select the appropriate Multiple Service Override Reason and Delay Reason, if needed. Click
Save.
14. Choose the Administrative Action Release and Finish. This encounter will be included in the next
Claim Batching process. Repeat as necessary.
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