Revised: Submitting a "Void" or "Corrected" Claim electronically Non-Medicare Payers

Date:   5/24/2010

If you want to submit a Void or Corrected claim to a payer please see guidelines listed below:

 

****Medicare will not accept a Void or Corrected Claim****

 

If you are submitting claims in a Print Image format, the following information must be located in Box 19 of the CMS1500 form:

 

Voided claims will need the word “VOID” followed by a space or hyphen followed by the original claim number.

 

Example:          VOID 123456789 or VOID-123456789

 

Corrected claims will need the word “CORR” followed by a space or hyphen followed by the original claim number.

 

Example:          CORR 123456789 or CORR-123456789 

 

If you are submitting claims in the ANSI 837P format you must populate your file with the following information:     

           

Voided claims will need the Claim Type Code Value “8” (Void of prior claim) in Loop 2300 CLM05-3.  REF01 must contain the value "F8" and REF02 must contain the original claim number

 

Corrected claims will need the Claim Type Code Value “7” (Replacement of prior claim) in Loop 2300 CLM05-3.    REF01 must contain the value "F8" and REF02 must contain the original claim number.

 

Provider Action:

Use the above instructions to submit a “VOID” or “Corrected” claim electronically.