Dental Claims

PES allows you to resubmit a claim(s) to Wisconsin Medicaid even after the claim shows a status of "paid." To resubmit a paid claim, click the dental button on your toolbar and follow these steps:

1. Select the claim you want to resubmit at the bottom of the Header 1 tab.
2. Click Copy.
3. Select "7" in the Claim Frequency box.
4. Enter the 15-digit internal control number (ICN) in the Original Claim # box. Refer to your Remittance and Status Report for the ICN, or look for the payer claim control number on your 835 Health Care Claim Payment/Advice transaction.
5. Make adjustments to the incorrect portions of the claim as needed.
   Note: In addition to the adjusted information, all correct details of the original claim must be included, as all details and amounts will be resubmitted in your adjustment.
6. Click Save.
7. Click Communication on the menu bar.
8. Click Submission.
9. Select "Web Server" from the Method box.
10. Select "Medicaid" from the Program box.
11. Click on the appropriate form type under Files to Send.
12. Click Submit.