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Post by hec on Mar 27, 2014 16:23:46 GMT -6
How do we do a "corrected claim" or resubmit a claimed that had been denied and now we need to fix it? If we just create a new form would Medicare think that we are billing it twice? Should we somehow be specifying that it is a corrected claim and not a new one?
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Post by KizerOpt on Apr 2, 2014 12:06:34 GMT -6
Speaking for Medicare, unless you are told to do a new claim on the remit, you have to call corrections in on the Medicare Clinical Reopening Line. Otherwise they will reject it as a duplicate. Hope this helps
Karen
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Post by hec on Apr 3, 2014 20:13:57 GMT -6
someone at crystal has told my staff to just create a new form and resubmit but I feel like that's not correct. should somehow note on that form its a corrected claim somehow right,
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Post by KizerOpt on Apr 4, 2014 9:03:46 GMT -6
Most insurance companies have different ways of doing corrected claims, Medicare requires a phone call for corrections, others want you to put CORRECTED BILL in line 19 with what is being corrected. Tricare will let you fax a corrected claim.
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Post by peter@crystalpm on Apr 8, 2014 18:29:33 GMT -6
How do we do a "corrected claim" or resubmit a claimed that had been denied and now we need to fix it? If we just create a new form would Medicare think that we are billing it twice? Should we somehow be specifying that it is a corrected claim and not a new one? On the new form, use box 22 and set the resubmission code to 7. You will need to add the original reference number in the text box to the right. If you are using ANSI, then click the "Additional ANSI Info" button on the claim and select "7" from the drop down at the bottom of the window near the "Continue" button. Once you continue to the second page, add an identifier for "Original Reference number" in the identifiers section. |
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Post by peter@crystalpm on Apr 8, 2014 18:32:52 GMT -6
someone at crystal has told my staff to just create a new form and resubmit but I feel like that's not correct. should somehow note on that form its a corrected claim somehow right, This was bad advice. I'm sorry you were told this. I'll try to do some more training with the customer service staff. |
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Post by hec on Apr 9, 2014 4:39:31 GMT -6
ok because I think they told my manager same thing again yesterday to just resubmit a new claim rather than doing what you suggest . I will forward the information you posted here to my staff because I'm sure this is not what they doing for corrected claims. thank you
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Post by hec on Apr 10, 2014 14:41:47 GMT -6
What is the "original reference number" that you are referring to? I see the box but what should we put in that box?
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Post by KizerOpt on Apr 16, 2014 15:21:20 GMT -6
I don't know about anyone else, but I could use some tips on using the Additional ANSI Info section. I'm trying to file a secondary claim to Bluecare after VSP, and the patient also has Cigna medical as primary. VSP doesn't have a payer id. All of which leaves me scratching my head. Are there any tutorials or cheat sheets out there?
Karen
Ok, just noticed also, if I select '7' by mistake on the CMS form, I can't get rid of it without regenerating and starting over. Granted, I may need the practice, but that's just annoying! |
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Post by bobbiejean on Jul 2, 2014 9:35:16 GMT -6
When you are referring to "new form" and using ANSI, I'm confused. Also what is the "original reference number" I am very new to this. Day 2 using Crystal.
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Post by KizerOpt on Jul 2, 2014 11:42:10 GMT -6
When you are referring to "new form" and using ANSI, I'm confused. Also what is the "original reference number" I am very new to this. Day 2 using Crystal. You might refer to Peter's thread 'Using ANSI 5010 in billing..." for more info about it. The 'original reference number' when submitting a corrected claim would be the original claim number on the insurance remit.
Karen
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Post by mdeyedoc on Jul 6, 2014 9:58:28 GMT -6
How do we do a "corrected claim" or resubmit a claimed that had been denied and now we need to fix it? If we just create a new form would Medicare think that we are billing it twice? Should we somehow be specifying that it is a corrected claim and not a new one? On the new form, use box 22 and set the resubmission code to 7. You will need to add the original reference number in the text box to the right. If you are using ANSI, then click the "Additional ANSI Info" button on the claim and select "7" from the drop down at the bottom of the window near the "Continue" button. Once you continue to the second page, add an identifier for "Original Reference number" in the identifiers section. Are you saying that this method of correction should work for Medicare and others that accept ANSI claims or do we still need to find out what out what each insurance co requires? Marcia |
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Post by peter@crystalpm on Aug 4, 2014 13:44:14 GMT -6
I believe that this should work for all since it is the "standard" set by ANSI, but I have been wrong before by making assumptions about what insurance companies will or will not do.
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Post by KizerOpt on Aug 4, 2014 14:34:04 GMT -6
I did find a Clerical Error Reopening Form from Cahaba which I'm using for our Medicare corrections in place of calling now. So far it's working, I haven't heard from Medicare whether they will accept ANSI corrections. And to tell the truth, it's WAY easier than figuring out the ANSI form!!!!
Karen
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