A corrected claim is any claim that has a change to
the original claim (e.g., changes or corrections to
charges, procedure or diagnostic codes, dates of service,
member name, etc.) Corrected claims may be submitted
In most instances, claims correction should be submitted in an electronic format.
- In the 2300 Loop, the CLM segment (claim information), CLM05-3 (claim frequency type code) must indicate one of the following qualifier codes:
The 2300 Loop, the REF segment (Claim Information), must include the original claim number issued to the claim being corrected. The original claim number can be found on your electronic claims receipt confirmation reports or electronic remittance advisement.
- “7” – REPLACEMENT (Replacement of Prior Claim)
- “8” – VOID (Void/Cancel of Prior Claim)
In the rare cases where a medical corrected claim must be submitted on paper, use the guidelines below:
Corrected paper claim
UB-04 paper claim
- Use the Type of Bill code 7 Replacement
of prior claim as the third digit and
indicate the changes in the remarks field.
Send corrected paper claims to:
P.O. Box 21267
Seattle, WA 98111-3267
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