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Void and Replacement Claim Help
 
How to void a claim
How to replace a claim
Void and Replacement FAQs

How to void a claim

A provider-initiated electronic void (formerly called claim reversal) is a cancellation of an entire claim.  A void can be completed on the same day or in the same week that the original claim was submitted, as well as after the original claim payment is finalized.  A region code of 63 is assigned to post-financial claims for electronic voids that are initiated by the provider.

To void a claim, perform the following steps:

  1. Using claim inquiry, view the claim you would like to void on the HIPAA-compliant 276 claim detail response page or the "Show me More" page.

  2. Click on the "Void This Claim" button.  A "Void This Claim" button will NOT be displayed if any one of the following is true:
    1. You do not have permission to submit claims via Web interChange.
    2. This claim was previously voided.
    3. This claim voided another claim.
    4. This claim is a Pharmacy claim.
    5. The status of this claim is Denied.

  3. The system will respond with a new window that states the system has received your void request.

After the void request has been submitted, the status of the original claim will be 'V/R Pending' until the void request has been processed.  At this time a region 63 claim will be created for post-financial claims.  The ICN for the region 63 claim can be found on the Claim History section of the "Show me More" page when inquiring on the original claim.


How to replace a claim

A provider-initiated electronic replacement (formerly called an adjustment request) is submitted with a claims frequency code of 7 and becomes a new claim (including attachments and claim notes).  A replacement can be completed on the same day or in the same week that the original claim was submitted, as well as after the payment is finalized.  New region codes are assigned to post-financial claims for electronic replacements that are initiated by the provider.

  • Region 61 - Provider initiated replacement claims with notes or attachments
  • Region 62 - Provider initiated replacement claims without notes or attachments

To replace a claim, perform the following steps:

  1. Using claim inquiry, view the claim you would like to replace on the HIPAA-compliant 276 claim detail response page or the "Show me More" page.

  2. Click on the "Replace This Claim" button.  A "Replace This Claim" button will NOT be displayed if any one of the following is true:
    1. You do not have permission to submit claims via Web interChange.
    2. This claim was previously voided or replaced.
    3. This claim voided another claim.
    4. This claim is a Pharmacy claim.
    5. The filing limit for submitting this claim has passed.

  3. The Claim Submission form will be populated with information from the original claim.  Make any desired changes to the claim fields and submit the claim.

    NOTE:

    The original claim being copied is examined to determine how to pre-populate the claim submission form with appropriate provider information (billing, rendering and detail rendering).
    1. If the provider has reported its National Provider Identifier (NPI) information to IHCP, then the claim submission form will be populated with the provider's NPI information and the Legacy Provider information fields will be empty.  You may modify the Postal Code and Taxonomy portion of the NPI information, but if the entered NPI information does not correspond to the billing provider of the original claim, the claim submission will not be allowed.
    2. If the billing provider has not reported its NPI information to IHCP, and is an atypical, non-healthcare provider, the claim submission form will be populated with the billing provider's Legacy Provider ID information and the NPI information fields will be empty.  This legacy billing information will not be allowed to be changed.

  4. The system will respond with a new window that provides the ICN of the new claim or states the ICN will be assigned when the replacement is processed.

After the replacement claim has been submitted, the status of the original claim will be 'V/R Pending' until the replacement claim has been processed.  At this time, you can inquire upon the new replacement claim.  If an ICN was not provided for the replacement claim, it can be found on the Claim History section of the "Show me More" page when inquiring on the original claim.


Frequently Asked Questions about Voids and Replacements
  1. Can only claims that were submitted via Web interChange be electronically voided or replaced?

  2. No, claims submitted electronically or via paper can be voided or replaced using Web interChange.

  3. Where can I find more information on Voids and Replacements?

  4. The IHCP 837 companion guides have been updated to reflect information about voids and replacements.  The companion guides are available at provider.indianamedicaid.com.

  5. How can I determine if a claim has already been voided or replaced?

  6. View the "Show me More" page for the claim.  If this claim has been voided or replaced, a Claim History section will be displayed.  The Claim History section will provide the ICN of the claim replacement claim or the void claim for post-financial claims.

  7. Can I change the billing provider on my claim by replacing the claim?

  8. No, replacement claims must be for the same billing provider as the original claim.  You should void the original claim and submit a new one.

  9. Can I change the claim type on my claim by replacing the claim?

  10. No, replacement claims must be for the same claim type as the original claim.  You should void the original claim and submit a new one.

  11. Can I void or replace a pre-financial claim?

  12. Yes, you can electronically submit a void or a replacement for both pre-financial and post-financial claims.

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