Author Topic: Cancelling a submitted claim???  (Read 2175 times)

dfranklin

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Cancelling a submitted claim???
« on: February 03, 2010, 02:50:53 PM »
How do you go about notifying the insurance company that a claim that was submitted needs to be cancelled.  Apparently my provider had sent me a superbill with the wrong date. They don't know what date it should be but the know the date submitted the patient was not seen. So they want me to notify the insruance company. (Insurance keeps sending letters asking for officenotes for this DOS).  So how do I notify them?

Thanks!

Pay_My_Claims

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Re: Cancelling a submitted claim???
« Reply #1 on: February 03, 2010, 06:22:13 PM »
I wouldn't notify them to cancel the claim, but you will need to do a claim correction. You need to notify the provider that he will need to contact the ins company saying there was an error on the claim the DOS was incorrect. document this so that you can have it for your records.

dfranklin

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Re: Cancelling a submitted claim???
« Reply #2 on: February 04, 2010, 12:30:13 AM »
The problem is another claim was submitted already for the correct date as they gave a second superbill to us before telling us about the mistake so we can't do a "correction" claim and change the date.  What should we do?

Nmanju

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Re: Cancelling a submitted claim???
« Reply #3 on: February 04, 2010, 05:59:56 AM »
You can call insurance company and tell them that the initial claim for the patient we submitted was with an incorrect date of service and we have resubmitted the claim with correct date of service and request them to consider the second claim and send for review. They will definitely process the claims.  i have came across such claims many a times.
 

Michele

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Re: Cancelling a submitted claim???
« Reply #4 on: February 04, 2010, 06:06:34 AM »
The part that concerns me is "They don't know what date it should be but the know the date submitted the patient was not seen." 

How can the provider not be able to figure out what the correct date was?  This is really key in how to handle this.  If the patient wasn't seen at all, you would notify them that the patient was billed in error.  But if it's an incorrect date, then you would notify them of that.  Two different scenarios that you can't decide which is correct without knowing. 

Michele
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Pay_My_Claims

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Re: Cancelling a submitted claim???
« Reply #5 on: February 04, 2010, 02:04:40 PM »
The part that concerns me is "They don't know what date it should be but the know the date submitted the patient was not seen." 

How can the provider not be able to figure out what the correct date was?  This is really key in how to handle this.  If the patient wasn't seen at all, you would notify them that the patient was billed in error.  But if it's an incorrect date, then you would notify them of that.  Two different scenarios that you can't decide which is correct without knowing. 

Michele


i agree

dfranklin

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Re: Cancelling a submitted claim???
« Reply #6 on: February 04, 2010, 07:48:47 PM »
One of their now ex-employee had screwed up on the date they wrote when they sent me the superbill.  Another employee was reviewing outstanding services that were not billed and sent a list to us that needed to be billed which we did.  She did not know that one was sent to us with the wrong date and we did not know it was wrong either until the carrier asked for chart notes on the claim and provider's office said they were not seen that day.

It is a chiro so the same patients are seen very often and sometimes daily so when you see a patient superbill for the same week or even the next day it does not raise any red flags to make you think it could be incorrect becuase that is quite common.

This is going to be eliminated in the near future as they will be using my appointment scheduler that way I can verify we have superbills for all patients seen and we don't have a superbill for a patient not on a schedule (and if we do then now we have a red flag to go off of).

I just wasn't sure how to handle this claim where I can not "correct" the date and submit since we already submitted one for that date and did not know that one was incorrect until later.

Michele

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Re: Cancelling a submitted claim???
« Reply #7 on: February 06, 2010, 07:07:22 PM »
That makes more sense.  I would just attach an explanation to the request for the office notes.  Explain that it was a clerical error, and all correct dates were submitted. 

Michele
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dfranklin

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Re: Cancelling a submitted claim???
« Reply #8 on: February 06, 2010, 07:38:25 PM »
OK...awesome! Thanks Michele!