Learning Resources
Frequently Asked Questions
| All categories |
WEB TOOL: SUBMIT A CLAIM |
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Can you resubmit a denied claim once correct on Web Tool?Yes. Copy the claim, correct it, and submit it. | |
Can you resubmit the same claim via the Web Tool?Yes, if you submit a new claim, you will get a new CCN. | |
Can you use the Web Tool for adjustments, if you filed through a clearinghouse?Yes, you may submit an adjustment through the Web Tool, even if the original claim was filed using a clearinghouse – as long as it is within 15-18 months. However, UB-04 (Institutional) billers must file adjustments in the same medium as the original claim. | |
Do you have to put in diagnosis codes?If the service you are providing requires the use of a diagnosis code, then you must enter the diagnosis code with your claim information. | |
Do you have to put the last 4 digits of the zip code for Claims Entry?Yes; you can find zip codes on the US Postal Services website: www.usps.com. Click on Look Up a Zip Code™ | |
Do you have to submit claims through Web Tool?No, you may use other options like hard copy or vendor/clearing house. | |
How do I file a replacement claim for a paid claim that is partly incorrect?Go to the Web Tool submission page. Log in; go to claims entry/history; click on the correct batch number; click on the correct claim number; copy; click the claim type on the left; click on batch, claim; edit; scroll down to claim submission reason code; select replacement. To complete this task, you must have the original Claim Control Number (CCN). | |
How do I know the charge?You can find the charge for the service in your provider manual. | |
How far back can you bill?Within 12 months | |
How far back can you file a void?15 - 18 months | |