NOTE: This change does not apply to Medicaid products, including Highmark Wholecare, Highmark Health Options Delaware, or Highmark Health Options West Virginia.
In Health Insurance Portability and Accountability Act (HIPAA) 837I and 837P claim transactions, the Frequency Type 7 claim is reported in the 2300 Loop, CLM05-3 element. The original claim number is reported in Loop 2300, as “Orig Clm No.”
For transactions via Availity®, corrected claims can be submitted within the claim entry screen by selecting Frequency Type 7 and providing the original claim number.
Here’s how the current correction or adjustment claims process works:
The Replacement Claim will now process as the new claim and any future reference to the changes would be made on the Replacement Claim. The Adjustment Claim will serve as a notification to providers that a correction has been made; the Replacement Claim will document the actual correction(s).