Corrected Claims

What is a corrected claim?

A corrected claim is a replacement of a previously submitted claim (e.g., changes or corrections to charges, clinical or procedure codes, dates of service, member information, etc.). A corrected claim is not an inquiry or appeal. Do not submit a Provider Inquiry Resolution Form (PIRF) with a corrected claim.

How do you submit a corrected claim?

Corrected claims should be submitted electronically to save time, money and help expedite claims processing - here's how:

  • Professional providers should submit claims in the HIPAA transaction 837P
  • Institutional providers should submit claims in the HIPAA transaction 837I

Professional and Institutional Providers claims should include:

  • A value of '7' in Loop 2300, Segment CLM05-3
  • The original DCN in Loop 2300, Ref*F8

We urge you to submit all claims electronically however, if you do not have electronic claims submission capabilities, you can submit them on paper with 'Corrected Claim' written at the top of the claim form.

For electronic and paper claims submission, please allow 30 days for processing prior to checking your claims status on CareFirst Direct or the CareFirst on Call.

Where can you get more information on corrected claims submission?

Register for a webinar today. The Center for Provider Education and Training has scheduled numerous opportunities for you and your staff to become more familiar with this process. Click the link to sign-up for a date and time convenient for you.