Correcting or Voiding Insurance Claims
At times, you may need to correct or void a claim that was submitted to the insurance company if you received an Explanation of Benefits or Electronic Remittance Advice indicating that a claim was denied or was paid incorrectly because of incorrect information that you submitted on the claim. Some examples of this are:
- Insurance paid the claim, but you erroneously charged the wrong CPT code, resulting in being paid less or more than expected for the session.
- Insurance denied the claim, indicating that the place of service requires a specific modifier to be included on the claim.
- You submitted a claim for a service that never took place, and need to tell the insurance company to VOID the claim.
This method is NOT USED for claims that have been rejected back to your dashboard – rejected claims only need ‘fixed’ and submitted and do not qualify for this process.
How To Submit a Corrected Claim
The following process will automatically insert the number 7 and the original claim reference number into box 22 on the claim form:
Identify the Claim Control Number that the insurance company assigned to the clam. This number will be found on the Explanation of Benefits or on the Electronic Admittance Advice report you received about the denial. You can also look up the claim number directly on the insurance company's web site in many cases if you do not have the EOB/ERA. Each individual claim has its own Claim Control Number.
Make corrections for the date of service. Go to the patient's billing tab in their profile and click on the date of service on the ledger.
On the resulting page, click on the description to open the invoice:
The resulting screen will provide a page where you can make corrections to the CPT code, amount charged, Place of Service, or any Modifier Codes on the claim, which are the most common corrections that are made.
After saving the screen above, on the resulting screen click on the Claim Button:
Select Correct/Void on the resulting screen:
Select REVISE Claim if you are requesting insurance to Pay the Claim based on the corrected information. Select VOID claim to indicate to the insurance company that this service never took place. Enter the claim control number and write a note to yourself about what you did to amend this claim. Save the Information.
You are now seeing a screen where the claim is 'open' for editing. However, we have already edited this claim with our previous steps! So you can just click the "submit' claim button on the right. However, if you have additional edits on the claim to make (which is very rare) you can make those on the screen below before submitting the claim.