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Claims & Billing
Corrected Claims

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 immediately.

Electronic claims
In most instances, claims correction should be submitted in an electronic format.

  1. In the 2300 Loop, the CLM segment (claim information), CLM05-3 (claim frequency type code) must indicate one of the following qualifier codes:
    • “7” – REPLACEMENT (Replacement of Prior Claim)
    • “8” – VOID (Void/Cancel of Prior Claim)
  2. 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.

Paper claims
In the rare cases where a medical corrected claim must be submitted on paper, use the guidelines below:

Corrected paper claim

  • Attach a Corrected Claim Cover Sheet (PDF) to your corrected paper claim. Include the following:

    • Complete all applicable fields on the Corrected Claim Cover Sheet.
    • Attach a copy of the original claim with the corrections added to the copy
    • Indicate the reason(s) for the correction (corrected charges, diagnosis, patient information, etc.)
    • Include the claim number that needs to be corrected. The claim number is located on your payment voucher.
    • Paper claims resubmitted with changes should be marked "corrected claim" in the upper right hand corner or in Field 24 of your CMS-1500 or ADA Dental claim form.

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:

Regence BlueShield
P.O. Box 21267
Seattle, WA 98111-3267

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