Reminder: Corrected claims must include the original claim ID

As a reminder, we require that corrected claims – submitted to either replace, correct or void an original claim that was partially or fully paid – include the original claim ID. We’ll soon begin front-end rejecting corrected claims that have an invalid / incorrect original claim ID. This will apply to both facility and professional claims for all plan types.

Note: For claims that were fully denied, providers should submit a new claim rather than a corrected claim. This update doesn’t impact this process.

Submitting corrected claims

If you’ve made a mistake on a claim submitted to us and would like to either correct, replace or void it, you can do so by submitting a corrected claim. Per our Provider Manual, the corrected claim must include the following elements:

  1. Appropriate frequency type code: 7 for correction or 8 for void
  2. Original claim ID number

Instructions are available in our Provider Manual for submitting corrected claims for both facility / UB-04 and professional / CMS-1500 claims. Ensure the original claim ID included in the required corrected claim field is correct to avoid a front-end rejection.

Viewing front-end rejected claims

You can see your front-end rejected claims in:

  • Prism, by using the Search Front-End Rejected Claims feature under the Claims tab
  • 277 report from your clearinghouse, if you work with one
  • Our service receipts, if you’ve signed up

If you’ve received a front-end rejection on a corrected claim for an invalid / incorrect original claim ID, you’ll see the following message:

“The original claim ID was entered incorrectly on this corrected claim. Please validate the original claim ID and resubmit.”

Front-end rejections aren’t denials. You can correct and resubmit the claim.