Claim Correction and Resubmission - Chapter 9, 2020 UnitedHealthcare Administrative Guide

Claim Correction and Resubmission

Electronic Process:

  • Some corrected claims can be submitted electronically as an EDI 837 transaction with the appropriate frequency code. Submit using EDI for the claims that process and pay appropriately.
  • The Claims (on Link) tool permits care providers to resubmit corrected claims that have been paid or denied.
  • If you received a letter asking for additional information, submit it using Claims (on Link).
  • When correcting or submitting late charges on 837 institutional claims, use bill type xx7, Replacement of Prior Claim. Do not submit corrected or additional charges using bill type xx5, Late Charge Claim.

Paper Process:

  • Submit a new CMS 1500 or UB-04 CMS-1450 indicating the correction made. Please attach the Claim Reconsideration Request Form located on Check Box number 4 for resubmission of a corrected claim.
  • Mail the information to the address on the EOB or PRA from the original claim.