A corrected claim can only be filed after you receive an Explanation of Payment for the original submission. Corrected claims can be submitted to provide additional information (e.g., service units, procedures, diagnoses, charges) or to cancel the original claim. Adhering to the following guidelines may reduce duplicate service denials or processing issues.
- For EDI submissions, enter “corrected claim” in the notes section; if submitting a corrected HCFA 1500 paper claim, write “corrected claim” somewhere on the claim
- All corrected claims must be submitted within 365 days of the original date of service. If a corrected claim is received after the 365-day time frame, the claim will be denied because of untimely filing.
- When submitting EDI or UB04 claims, the type of bill should end with the numeric value 7 (which represents a corrected claim).
- Do not attach the original claim with the corrected claim, as the corrected claim replaces the original.
- File all services for a patient for a particular date of service on the same corrected claim.
- Include all services to be considered for payment when submitting a corrected claim, even those already paid under the original claim. (If you submit a corrected claim with only charges that have changed, it will appear that you intend to remove all previously processed charges, which will result in a negative balance (offset) of the previously paid amounts.)
- To remove charges, indicate the change by not placing the charge on the corrected claim. Do not submit a zero charge line.
- To change a patient’s ID number or date of service, submit a corrected claim with the appropriate information and services to cancel charges for the original claim.
- Do not mark claims as “corrected” if you are sending additional information (such as medical records or the primary carrier Explanation of Payment) that we requested to process the original claim. Only mark the claim as “corrected” if you are making a change to the original claim submission.