December 2025
Help prevent claim denials and support timely claim processing with the following actions.
When a service confirmation is generated for a member, it places a hold on their available benefits. If the service is not performed and the confirmation remains active, the member cannot use those benefits.
Regularly review your confirmations and cancel any that correspond to services not completed. Doing so helps ensure members can access the care they need without unnecessary delays.
When submitting a corrected claim, you should update at least 1 element of the original submission. Examples of changes include procedure codes, modifiers, dates of service or billed amounts. Claims submitted without changes will be denied as duplicates.