Rebill & correct

Outcome

A claim that was rejected (277CA) or denied (835 with CO adjustments) is corrected — either automatically by the engine or manually by you — and a new claim flows out under a parent/child relationship that preserves audit history.

Prerequisites

Scope	What it lets you do
billing.claim.read / .write	Reverse and rebuild
billing.charge.write	Edit charges that need fixing
billing.denial.read	Trace the denial that triggered the rebill

The rebill model

Every rebill carries parent_claim_id pointing at the originating claim, so audit and reporting can walk the chain. The original claim moves to REBILLED (terminal), the new one starts at CREATED.

When the engine handles it (most CARCs)

The auto-correction engine has handlers for common CARCs. If you see a SUCCESS row on the denial's Auto-correction tab, it has already built and submitted the rebill. Don't manually rebill on top of it.

CARC	Handler	What it does
CO-4	CO4ModifierHandler	Re-injects modifiers and rebuilds.
CO-16	Co16MissingInfoHandler	Attaches missing info / auth and rebuilds.
CO-29	Timely-filing handler	Generates appeal envelope (timely-filing exception) where rules allow.
CO-18	Duplicate handler	Marks the duplicate; no rebill (the original paid).
CO-97	Bundling handler	Re-codes per CCI rules and rebuilds.
CO-197	Auth handler	Attaches auth and rebuilds.

See 5.3 — Auto-correction console for the full handler list and how to override.

Manual rebill

When the engine can't fix it, or the engine has tried and failed:

1. Open the denial at /denials/:id. Read the CARC and any RARC.

2. Click Open in rebill. The platform reverses the original claim (reverses pricing, releases the auth's used_units), unlocks the charges, and opens the Edit charges view.

3. Make the fix. Edit the charge that triggered the denial — wrong modifier, wrong code, wrong DOS, wrong unit count. See 2.6 — Edit / correct a charge.

4. Re-build the claim from the same set of charges. The new claim inherits parent_claim_id. Submit per 3.1.

Reversing without rebuilding

You can reverse a claim without immediately rebuilding when the charge needs upstream-EMR repair. The reversal:

• Releases used_units on attached auths.
• Reverts pricing rows.
• Sends the charge back to VALIDATED (or NEEDS_FIX, depending on re-validation).

You'll rebuild when the upstream fix is done and the charge re- validates.

Mass rebill (after a rule fix)

Sometimes a denial pattern traces to a stale rule (e.g. you missed a modifier-injection rule for a payer). After admin fixes the rule:

1. Filter denials to the affected CARC and date range.

2. Bulk select, click Trigger auto-correction. The engine re-runs all selected. Rows that the new rule fixes get SUCCESS rebill rows.

3. Watch the worklist. Successful rebills move to RESOLVED; failures stay open for manual handling.

Validation

Check	Expected
Original claim status flips to REBILLED	Yes (terminal).
New claim's parent_claim_id points at original	Yes; visible on the Relationships tab.
used_units on auth releases on reverse, re-consumes on rebuild	Yes; net-zero on a successful rebuild.
Audit log captures reverse + rebuild as separate events	Yes.

Troubleshooting

Symptom	Cause	Fix
Open in rebill greyed	Original claim is already REBILLED or WRITE_OFF	Look for the child claim on Relationships; act there.
Re-built claim fails the same validation	Your edit didn't address the root cause	Re-read the CARC text + RARC; sometimes the fix is in the auth, not the claim.
Engine ran but SUCCESS rebill is also denied	New denial has a different CARC	Triage as a fresh denial; the chain depth grows.
used_units exceeds approved after rebuild	Rebuild ran while a parallel claim was billing	Reverse one, rebuild the other; ask admin to consider an auth amendment.

Where to next

• 3.4 — Void & replace — for the cases that need a payer-side replacement (frequency code 7 / 8).
• 5.3 — Auto-correction console — the engine in detail.