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Submit replacements for partially denied claims starting July 1
June 15, 2018

Please share this communication with your billing department or billing agency.

When you need to make changes to a partially1 denied claim, remember to submit a replacement claim, just as you do for a fully denied claim. As of July 1, 2018, Provider Service will no longer adjust claims to make these changes for you.

Please don’t send supporting documentation, such as a provider detail advisory (PDA), with your replacement claim. It will cause the claim to suspend and delay processing.

Resources

  • The March 1, 2018 News Alert, Replacement claims mandate to include partially denied claims. To read the News Alert, log in and go to News>Claims, Coding, Payment.
  • Frequently asked questions

Questions?
If you have any questions, please call Provider Service at
1-800-882-2060. As always, thank you for the care you provide to our members.


1 A partially denied claim means some lines on the claim rejected.

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