When resubmitting a claim to MedCost as a corrected claim, the guidelines shown below must be followed to ensure timely and accurate adjudication using the corrected information. Corrected claims that are not filed according to these guidelines will be denied.
A corrected claim is the resubmission of an existing claim with a specific change or addition to the original information, filed with the appropriate corrected claim indicator.
All corrected claims should be filed through your normal claim submission channel. The successful submission of a corrected claim will result in the retraction and replacement of the original claim. For faster and more accurate processing, the preferred method for submitting claims to MedCost is via electronic data interchange (EDI).
Guidelines for Filing a Corrected Claim to MedCost
- For UB-04 claims, a “7” must be present as the third digit of the Type of Bill field. For paper claims, the original claim number should be entered in Field 64.
- Professional claims also should reflect a claim frequency code of “7.” For paper claims, the original claim number should be entered in Box 22.
- Edit the claim with the corrected information.
- Include the payer’s original claim number in the 2300 claim loop - segment REF01=F8 and REF02=the original claim number with no dashes or spaces.
- Enter the original claim number of the paid/denied claim when submitting a replacement with frequency of “7” (Replacement of Prior Claim). CLM05-03 (837P).
- In the 2300 Loop, the REF02 segment [Original Reference Number (ICN/DCN)] must include the original claim number issued to the claim being corrected. The original claim number can be found on your Remittance Advice.
- Resubmit through normal channel.
Failure to include the original claim number and/or use a corrected claim indicator may impact the processing of your claim. Please note, a corrected claim does not constitute an appeal.
Paper Claims - Billing Provider Address
Effective March 1, 2022, in alignment with industry standard guidelines, all paper claims must be filed as follows:
The billing provider address cannot contain a PO Box or Lock Box, and a physical address of the practice must be included in the following location of the claim form:
Claim Form Type Location
HCFA Box 33
UB Box 1
Failure to file in accordance with these requirements will result in the claim being rejected. An image of the claim with a cover letter will be mailed back to you, delaying your claim processing time.