Claim Forms: Correct a Claim - Box 22

If a claim has been rejected by your Clearinghouse, or denied by the insurer, corrections can be made to the original claim form direction within Healthie - to then be resubmitted. 

Updating a Claim 

To correct and resubmit a claim, locate and edit the original claim within Healthie.  

• Client Profile > Billing > CMS 1500s
• Locate the claim, and click the actions tab (three dots) > Edit Claim

Alternatively you can go to your main Billing tab > CMS 1500s and take the same actions to Edit the claim. 

Once you have opened the claim, you can make the necessary updates to the form. 

Resubmission Code & Original Reference Number

If the original claim was denied by the insurer, then there are two fields in the Miscellaneous Info section that you will need to fill out: Resubmission Code and Original Reference Number. 

Note: We recommend updating the existing claim form, and populating these fields to resubmit the claim, rather than creating an all new claim. This will allow you to better track your claim and maintain accurate financial records. 

Resubmission Code 

Indicates to the insurance payer why the claim is being resubmitted. Make a selection from the drop-down. 

• 6 - Correction of prior claim 
• 7 - Replacement of prior claim 
• 8 - Void/cancel of prior claim 

Original Reference Number 

The Original Reference Number is assigned by the insurance payer to indicate a previously submitted claim or encounter. This is also known as the Claim Reference Number or ICN. If this is not filled out, the insurer will not be able to reference the original claim when processed your request. 

On the CMS 1500 claim when updated, the resubmission code and original reference number will populate into Box 22. 

Resubmit a Claim 

After corrections have been made to the claim, along with population the original reference number and resubmission code fields, you can then take the same actions you normally would to submit the claim. 

• Export the claim as a TXT file and upload it to your clearinghouse or insurance payer portal 
• Send the claim to Office Ally via Healthie's direct integration

Learn more about tracking your claim status here.