Corrected Claim Submissions
| Date: | June 04, 2025 |
| From: | Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) |
| To: | Health Plan All Providers |
| Type: | Informational/Educational |
| Subject: | Corrected Claim Submissions |
| Business: | Medi-Cal Managed Care |
Corrected Claim Submission Reminder
When submitting a correction for a previously submitted claim the following are required:
- Enter the CLAIM FREQUENCY TYPE as 7, for replacement/correction
- Electronic: 2300 loop in the CLM*05 03
- Paper: Box 22 (resubmission code)
- Enter the ORIGINAL CLAIM NUMBER in the original ref. no. field
- Electronic: 2300 loop in the Ref*F8*
- Paper: Box 22 (Original Ref. No.)
Note: Corrected claims are required to be billed with ALL line items filled out for that claim, and they should never be billed with just the line items that need to be corrected.
If your claim denied as duplicate and it was not sent with the right indicators for a corrected claim submission, do not submit a dispute. A new correction will need to be submitted.
As of June 18, 2025, if a claim is billed with claim frequency 7, and the Original Ref. No. field is left blank, paper or electronic, the claim will be rejected and a new claim will need to be submitted for correct processing and payment.
If you have any further questions, please contact your Provider Services Representative, or call our Customer Service Department at 1-888-936-PLAN (7526). You may also visit https://www.hpsj.com/alerts/ for online access to the documents shared. The most recent information about Health Plan and our services is always available on our website www.hpsj-mvhp.org
