Reverse Claim

This guide is essential for anyone needing to reverse a claim efficiently. Users can navigate the reversal process, understand the implications of claim statuses, and avoid potential errors.

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Bluecross

Step 1: Search Claims History

Click **"CLAIMS"** from the top menu bar and select **"Search Claims History"**

1. Review the Automatically Generated Provider Information ***For offices with multiple providers***, verify that the claim is associated with the correct provider who submitted it.\ \ 2. Enter Search Criteria. Select the **date range** for the claim and the member’s **Identification Number.**\ \ Click **"Search"** to generate the results.

Click **"View"** to generate the claim details

Step 2: Reverse Claim

Refer to the **Claim Type** field to determine the current status of the claim: - **In Process:** The claim has been submitted, but payment has not yet been issued to the clinic or provider. The claim will be automatically reversed. - **Paid:** The claim has been processed, and payment has been made to the clinic or provider. Reversing the claim will result in an "amount owing" to Saskatchewan Blue Cross, which will be adjusted when future claims are submitted.

On the **Claim Details** page, select **"REVERSE CLAIM"** to initiate the claim reversal. ***Note:*** *If the claim was submitted as part of a batch with multiple claims, all claims within that submission will be reversed.*

Input the reason for the claim reversal (e.g. claim amount error) Click **"REVERSE"**

Confirmation that a claim has been successfully reversed will generate and the claim will be removed from the search history.