Changes coming Jun. 15, 2020 to how we display corrected claims in your remittance advices

Based on your feedback and to better align with industry standards, we’re making changes to the way we display corrected claims in your remittance advices (RAs). We’re making this change to clearly distinguish between corrected claims and denials.

These changes will only impact provider-initiated claims reprocessing. Claims adjustments initiated by Priority Health will not be impacted.

Background

Currently, our standard paper remits and our electronic RAs (835s) include a voided claim record with a corrected claim. The voided claim record displays as $0.00 and is often misinterpreted as a denial. The voided claim record also displays a slightly different claim number than the original claim number, adding to the confusion.

Additionally, both types of RAs do not currently display the original claim number associated with the corrected claim on the corrected claim record, making it difficult to tie the corrected claim back to the original claim.

We’ve heard you and are making changes effective Jun. 15, 2020 to our standard paper remits and 835s that address both areas of concern.

What’s changing: standard paper remits and electronic RAs (835s)

  • Voided claim records will no longer be included, to help you clearly distinguish between corrected claims and denials
  • The original claim number associated with the corrected claim will be included with the corrected claim record, making it easier to tie the corrected claim to the original claim

What’s not changing:

  • Your time frame for receiving RAs will not change
  • Claims adjustments initiated by Priority Health will not be impacted by these changes