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Claim correction and resubmission - Chapter 10, 2022 UnitedHealthcare Administrative Guide

Electronic process:

  • Corrected claims can be submitted electronically as an EDI 837 transaction with the appropriate frequency code. For more details, go to uhcprovider.com/ediclaimtips > Corrected Claims.
  • Check claims in the UnitedHealthcare Provider Portal to resubmit corrected claims that have been paid or denied.
  • If you received a letter asking for additional information, submit it using Claims in the UnitedHealthcare Provider Portal.
  • 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.
  • When correcting or submitting late charges on a 1500 professional claim, use the following frequency code in Box 22 and use left justified to enter the code. Include the 12-digit original claim number under the Original Reference Number in this box.
    • Frequency code 7 Replacement of Prior Claim: Corrects a previously submitted claim.
    • Frequency code 8 Void/Cancel of Prior Claim: Indicates this bill is an exact duplicate of an incorrect bill previously submitted. This code will void the original submitted claims.

Paper process:

  • Submit a new CMS 1500 or UB-04 CMS-1450 indicating the correction made. Attach the Claim Reconsideration Request Form located on uhcprovider.com/claims. 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.