A corrected or replacement claim is a replacement of a previously submitted claim (e.g., changes or corrections to charges, clinical or procedure codes, dates of service, member information, etc.). The new claim will be considered as a replacement of a previously processed claim.corrected or replacement claim is a replacement of a previously submitted claim (e.g., changes or corrections to charges, clinical or procedure codes, dates of service, member information, etc.). The new claim will be considered as a replacement of a previously processed claim. A corrected claim is not an inquiry or appeal.
What is a corrected claim?
A corrected claim is a replacement of a previously submitted claim. Previously submitted claims that were completely rejected or denied should be sent as a new claim.
When should you submit a corrected claim?
A corrected claim is appropriate to submit when the provider made an error in the information initially submitted on a claim. is simply creating a new claim and submitting it through your preferred clearinghouse. If you resubmit a claim that has been denied, the new claim will be denied as a duplicate claim.
What is the resubmission code for a corrected claim?
Complete box 22 (Resubmission Code) to include a 7 (the “Replace” billing code) to notify us of a corrected or replacement claim, or insert an 8 (the “Void” billing code) to let us know you are voiding a previously submitted claim.
What is claim resubmission?
For Claims: A “Resubmission” is defined as a claim originally denied because of missing documentation, incorrect coding, etc., which is now being resubmitted with the required information.
What should be included in a corrected or replacement claim?
The corrected or replacement claim should list all line items included in the original claim. Only listing the line items being corrected may result in recoupment of services that were paid on the original claim. Providers who submit paper claims can use XPressClaim ® to submit corrections.
What are replacement claims and how do they work?
Replacement claims are submitted when all or a portion of the claim was paid incorrectly or a third-party payment was received after MDHHS made payment. When replacement claims are received, MDHHS deletes the original claim and replaces it with the information from the replacement claim.
What is a corrected claim in medical billing?
Corrected Claims A corrected claim is a claim that has already been processed, whether paid or denied, and is resubmitted with additional charges, different procedure or diagnosis codes or any information that would change the way the claim originally processed.
What happens when you correct a line on a claim?
If the original claim had 10 line items and one line needs to be corrected, resend the claim with the corrected line and the other nine lines as they originally appeared on the claim. When payors correct claims, they void the original claim and reprocess the claim with all items being resubmitted, including corrected items.
