Medical Billing of Corrected Electronic Claims

To avoid Duplicate Denial from insurance, the providers, medical coders or medical billing companies always need to send corrected Medical claim to insurance when there is change or correction require in a original submitted claim.

Most of insurances companies accept corrected claim electronically with reference number of original paid claim. If original claim was fully denied then there is no need to mention the original claim number.

How to Submit Corrected Electronic Medical Claim

Medical Claim using the HIPAA 837 EDI that include the following information.

For corrected Electronic Claim frequency code must be number seven or eight in Loop 2300, CLM segment as per requirement. Frequency code 7 indicates correction of previous claim and Frequency code 8 indicates cancelation of previous claim.

In the 2300 Loop, the REF01 must contain “F8” and REF02 must have the original claim number issued to the claim being corrected. The original Medical claim number can be found on your electronic remittance advice.

For reason of Correction or Replacement claim comments must the updated in 2300 Loop NTE segment, it should be as below:

• Corrected CPT code
• Corrected ICD Code
• Corrected Claim
• Corrected Billing provider info
• Correct modifier added

Corrected Electronic Claim 837 EDI Example

CLM*0321930068*300***11::7*Y*A*Y*Y**
REF*F8*123456(claim number)

Note: Except Medicare for all Electronic insurance payers like United Health Care, BCBS, Aetna, CIGNA and GHI.
Medical Billing for corrected Electronic claim is in same way but in case if additional documentation like Medical record is needed by insurance then you must submit claim using HCFA 1500 form along with require documentation and mail out to insurance address.