---
title: "NHCX Reprocess Claim"
description: "How to search for and reprocess a rejected, disputed, or partially-paid claim with supporting documents."
date: 2026-08-21
lastModified: 2026-08-21
category: "nhcx"
author: "Dr. Umesh Bilagi"
beta: true
---

## Overview

When a claim is rejected, disputed, or only partially paid, you can ask the payer to **reprocess** it. The reprocess flow first searches for the claim to confirm its current status, then submits a reprocess request with a reason, the disputed amount, and supporting documents.

## Where to find it

Open the patient's NHCX page, find the workflow, and choose **Reprocess**.

## Step 1 — Search

The **Search** step confirms the claim exists and fetches its current status.

1. Enter the **Claim Number** (pre-filled from the workflow).
2. Add a **Description** if needed.
3. Submit.

## Step 2 — Reprocess

The **Reprocess** step submits the request. Fill:

- **Reason Code** — why the claim is being reprocessed:
  - **Reprocess request due to claim rejected by payer** (`claimrejected`)
  - **Rejection is disputed — additional evidence provided** (`rejectiondisputed`)
  - **Reprocess request due to partial payment by payer** (`partialpayment`)
- **Amount** — the disputed/remaining amount (for partial payment).
- **Supporting Document** — a PDF or JSON document providing evidence for the reprocess.
- **Appeal Justification** — free-text justification.

The claim number and intimation number are carried from the workflow.

## Common Issues

- **Supporting document required** — the reprocess request needs a supporting document attached.
- **Wrong reason code** — choose `partialpayment` only when the payer has made a partial payment; use `claimrejected` or `rejectiondisputed` otherwise.

## FAQ

**Q: When should I use reprocess vs cancel?**
A: Cancel is for withdrawing a pre-authorization before/around treatment. Reprocess is for getting a payer to re-look at an already-submitted claim (rejected, disputed, or underpaid).

**Q: What amount do I enter for partial payment?**
A: Enter the amount still in dispute (the portion the payer did not pay). The amount is only sent when the reason is `partialpayment`.

**Q: What format should the supporting document be?**
A: PDF is typical. JSON files are sent as FHIR JSON.