Correct, Void, or Edit an Insurance Claim
In this Article:
It's confusing because the language is the same, but there's actually a BIG difference between making a correction and resending a claim and sending in a Corrected/Revised claim. Claims that are rejected at Clearinghouse level (by Office Ally) are not considered corrected claims.
It is also not considered a corrected claim if the original claim was 'un-processable' for some reason – for example: If the ID Number was not correct. So while you may MAKE a correction (correcting the ID Number) if the original claim was un-processable – you're not sending in a CORRECTED claim. What you're doing is sending in a NEW claim with the correct information.
Corrected Claims:
If the claim was DENIED after the claim was processed because there’s a mistake on the claim (e.g. the wrong CPT code was used) → that would be a CORRECTED claim
Voided Claims:
Edit Claims
If the claim is REJECTED because the insurance company couldn’t process it for some reason (e.g. an invalid ID, DOB, spelling mistake) → that would be an EDIT.
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:
Step 1:
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.
Step 2:
Make corrections for the date of service.
- From the client profile → Billing (top tab)
- Click on the CPT Code description
Step 3:
- On the resulting page, click on the description to open the invoice:
Step 4:
The resulting screen will provide a page where you can make corrections.
The most common corrections made are:
- CPT code (top)
- Unit Price (middle)
- Place of Service (bottom)
- or any Modifier Codes (bottom) on the claim
Click (bottom right) when done.
Step 5:
After saving, on the resulting screen click on Claim (top tab).
Step 6:
Select (top right):
Step 7:
Select REVISE the prior claim if you are requesting insurance to Pay the Claim based on the corrected information. Enter the Original Claim or Reference Number and optionally write a note to yourself about what you did to amend this claim.
Then click
Step 8:
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.
How To Submit a Voided Claim
The following process will automatically insert the number 8 and the original claim reference number into box 22 on the claim form:
Step 1:
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.
Step 2:
- From the client profile → Billing (top tab)
- Click on the CPT Code description
Step 3:
Then click on Claim (top tab).
Step 4:
Select (top right):
Step 5:
- Select VOID the prior claim to indicate to the insurance company that this service never took place
- Enter the Original Claim or Reference Number and optionally write a note to yourself about what you did to amend this claim
Clicking will automatically set the voided claim, you will not need to click submit.
How To Edit and Resubmit a Claim
The following process will reopen the claim and allow you to resubmit with the edits you have made.
Step 1:
Make corrections for the date of service.
- From the client profile → Billing (top tab)
- Click on the CPT Code description
Step 2:
The resulting screen will provide a page where you can make corrections.
The most common corrections made are:
- CPT code (top)
- Unit Price (middle)
- Place of Service (bottom)
- or any Modifier Codes (bottom) on the claim
Click (bottom right) when done.
Step 3:
Then click on Claim (top tab).
Step 4:
Select (top right):
Enter a memo for why you're unlocking the claim, then click
Next, click , then at the top right.