Corrected Claims

If the information on an already processed (paid or denied - not returned) claim (where a remit has been issued) is incorrect or charges need to be added or voided, you must submit a corrected claim electronically.  
 
Some examples of when you would submit a corrected claim could include (not limited to): 

• Changing Current Procedural Terminology (CPT) code 
• Changing diagnosis 
• Changing place of service 
• Adding a modifier 
• Changing date of service 
• Adding or removing charges, etc.  

*Do not submit with a Reconsideration Request form.
 
Steps to submit a corrected claim electronically:

1. Place a value of 7 (replacement of prior claim) or 8 (void/cancel of prior claim) in Loop 2300 Segment CLM-Claim Information Field 05-3-Claim Frequency Type Code in the 837 file.
2. Enter the original claim number assigned by Blue Cross and Blue Shield of Nebraska (BCBSNE) in Loop 2300 Segment REF*F8 - Payer Claim Control Number Field 02-Reference Identification.
   1. These two element/segment values on the electronic claim form correspond to Box 22 on an 837P or Boxes 4 and 64 for an 837I (Claim Frequency Type Code and Claim Original Reference Number/Document Control Number) on the CMS claim form.
3. Type of Bill (TOB) 7 indicates you are replacing a previously submitted claim so do not change or remove data that needs to process again – submit the complete claim with the changes made.

Claims submitted and processed under an incorrect patient and/or member identification (ID) number will need to be voided before a new claim is submitted.  

1. Resubmit the claim as it was originally submitted, but with a claim frequency code 8 to void the inaccurate claim record. 
2. Submit a new claim with correct patient and/or ID information using claim frequency code 1.
3. Claims with frequency code 1 do not need a claim number submitted in the original reference number field. 

If you are not able to file your corrected claim electronically because your claim will include attachments, you must file your corrected paper claim to BCBSNE with the attachments. Do not submit corrected claims using a Reconsideration Request form.  
  
Do not send only the claim with “corrected claim” or “replacement claim” written or typed on the claim itself, as it will be returned and should follow the steps above. Corrected claims submitted as reconsiderations will be returned and should be submitted electronically following the steps above.  
 
Submitting a new claim to replace one that has already been filed may result in a duplicate denial.  

NEW for migration of claims system: When a corrected claim is submitted, the billed amount for the corrected claim will be the same as the original billed amount on the remits and EOBs. BCBSNE will correct as submitted by the provider; this will be reflected in the allowed amount and the paid amount. The billed amount will always reflect the original claim amount.