Claim correction/resubmit
If you need to correct and re-submit a claim, submit a new CMS-1500 or UB-04 indicating the correction being made.
When correcting or submitting late charges on a CMS-1500, UB-04 or 837 Institutional claim, resubmit all original lines and charges as well as the corrected or additional information. When correcting UB-04 or 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. Hand-corrected claim re-submissions will not be accepted.
Electronic Claim Submission
(EDI Support Line)
(800) 842-1109
To obtain information on HIPAA Transactions & Code sets go to hipaa.uhc.com Uniprise
Companion Document Additional United Healthcare and Affiliates’ payer ID scan be found on UnitedHealthcare Online.com
Claims & Payments Electronic Claims
Submissions, under EDI Tools & Resources
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Hi. You can find a blank Fillable CMS 1500 Insurance Claim Form here.
ReplyDeletehttp://goo.gl/0QhLF0
Please feel free to use it. You can fill out the form, save it, fax it, and email it.