While it is never advised to change a claim after it has been paid to a provider, sometimes it is necessary. Keep in mind the following:

1) If a claim is EVV required changing could result in non-payment. Although Spokechoice has the ability to send changes to the aggregator some functions are not possible: For example, changing a date.

2) If a claim is payroll paid, you must reverse that and change the claim and 'then' mark it payroll paid again. Failure to do that will result in the provider being paid again.

3) Careful attention should be paid to for overlap and authorizations. Because a claim is consuming authorizations changing it could result in a message denying change for lack of authorizations. This might require deleting the whole claim and reentering it.

4) Careful attention during the approval process should, in most cases, reduce the need to change claims. For example: if someone is not supposed to work overnight those types of claims during the approval process should be caught. This happens when a provider forgets to clock out and answer the "did you forget to clock out" message incorrectly.

To change a claim it can not be payroll paid or payer paid. You must first reverse both of those. This is a feature to keep people from arbitrarily changing things and having payroll come out of sync.

To reverse payroll paid or payroll paid click here. Note: Changing a paid claim does NOT send a change notice to Wellsky. You must manually do that within Wellsky

Change your claim as needed.

Add payroll paid back to the claim. Click here to learn how to do that. Note: If you do not do this and it was prior payroll paid the provider will be paid again with export of payroll.