For provider name, NPI number, member name, or member ID number changes, you must first process a void claim, and then file a new claim.The process for correcting an electronic claim depends on what needs to be corrected: Missing NPI Number: If we reject a claim for a missing NPI number, you must send it as a new claim with updated information.Īdditional documentation requested: If we requested additional information, simply resubmit the claim with the additional documentation.The EDI void and replacement requests do not include the required information, such as the original claim number.The original claim number is not included on a void, replacement or corrected claim.The NPI is incorrect, is not listed on the claim or does not match the recorded tax identification number registered in our system.The most common reasons we reject claims are:

You must correct claims that were filed with incorrect information, even if the claim has been paid. Please return the form within 60 days of receipt of the overpayment by mail or fax. If you received an overpayment, complete this form to credit the money back to us. If you receive a check with the wrong pay-to information, send it back to us at the above address along with the correct provider pay-to-information. See detailed instructions for filling out this form. Just save the form to your computer, fill in the data, print it, and mail it to the address above. You can enter your claims data directly on the CMS-1500 form from your computer. Sending claims via certified mail does not expedite claim processing and may cause delays.Įnter your claims data on the CMS-1500 form. mail to the address below for covered services given to WellSense Health Plan members. Medicare Advantage - New Hampshire Show subnavigation for Medicare Advantage - New Hampshire >.Medicaid - New Hampshire Show subnavigation for Medicaid - New Hampshire >.Senior Care Options - Massachusetts Show subnavigation for Senior Care Options - Massachusetts >.Qualified Health Plans - Massachusetts Show subnavigation for Qualified Health Plans - Massachusetts >.MassHealth Medicaid - Massachusetts Show subnavigation for MassHealth Medicaid - Massachusetts >.ConnectorCare - Massachusetts Show subnavigation for ConnectorCare - Massachusetts >.

Medicare timely filing limit 2015