Claim Indicator

You have the ability to submit corrected, late, or voided claims electronically by using the Claim Indicator page. Not all insurance companies have the ability to accept electronic corrected claims. This tool is especially useful for practices in Minnesota whose payers do not accept paper claim submissions. If you would like to simply rebill a date of service, check out the Demand Claims page. You can use the Notes field on this page to populate Box 19 on a CMS-1500 or Loop 2300, Segment NTE02 on a professional claim file (837P). If you would like to simply rebill a date of service, check out the Demand Claims page.

Medicare
  • This tool should never be used for Medicare. Always use a Redetermination or Reconsideration form when correcting Medicare claims.
  •  Medicare Part A does not accept corrected claims for Institutional Billing. Any corrections must be submitted through the payer's DDE portal.

Accessing the Page

  1. To access the Claim Indicator page, navigate to the Billing menu, and select Claim Indicator
  2. Enter your search criteria and click Search. 

    1. Patient: Enter the name of the patient whose claims need resubmission.
    2. Insurance: Displays a list of insurance companies associated with the patient account selected. Indicate which insurance should receive the claim resubmission. Remember, the patient's primary insurance will be listed first.
    3. Date of Service: Enter a single date or date range for the charges that need to be resubmitted.
    4. Payer Group: This field automatically populates with the insurance's payer group (payer groups are used to apply specific claim formatting). This field may be blank if the insurance does not have a payer group.
  3. Submitting Corrected, Late, and Voided Claims electronically.

    1. Claim #: Enter the original claim number that the insurance company has assigned to the claim.
    2. Action: Select the type of claim you want to resubmit. Your options are Corrected, Late, Void, and Conditional. 
      • Selecting Corrected will populate the 7 (Replace/Resubmission) Frequency Code on the claim.
      • Selecting Late will populate the 5 Frequency Code. This is helpful to add additional items to the original claim.
      • Selecting  Void will populate the 8 Frequency Code. This will cancel the claim.
      • Select Conditional for UB04.
    3. Late Reason: If the Action you selected is Late, you must make a selection for Late Reason. You must choose one of the options available on this list.
    4. Condition Code: You can include any required condition codes in this field. Typically, this applies to institutional claims (UB-04). 
    5. Note: Include a related note. This ties directly to Box 19 on the CMS-1500 claim form which is used to identify additional information about the patient’s condition or the claim. See the NUCC 1500 Health Insurance Claim Form Reference Instruction Manual for additional details. You will need to add the note to each line you rebill. 
    6. Rebill: Click the checkboxes for the line items you need to resubmit.
  4. Save: After you have entered all of the required information, click Save to begin the rebilling process.

Actions

The Claim Indicator page gives you four options for electronic resubmissions: Corrected, Late, Void, and Conditional.

  • Corrected: This option should be selected if you are updating information on the claim, such as the diagnosis code or the number of units. You must resubmit all charge lines that were on the original claim, even if only one line needs correction. 
  • Late: This option should be selected if you are submitting a claim to an insurance company for the first time but the Date of Service falls outside of their timely filing limits. Late Reasons are official options in the ANSI specifications so custom entries cannot be added. 
  • Void: If your claim was submitted with the wrong provider or wrong treatment date, you can use the Void action. After the claim is voided by the payer, you must then submit a claim with the correct information. 
  • Conditional: This Action is not functional. If you need to submit a Conditional/Institutional electronic claim correction, contact edi.help@webpt.com.
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