Tips for Submitting Electronic Claims
Attachments
The 4010 837 transaction allows for providers to submit a claim electronically while submitting attachments on paper. Elements in the file will indicate if you are sending an attachment, the type of attachment you are sending, an identification number for the attachment and the mode for sending the attachment (fax, email, etc).
UUHP feels this is a valuable tool and would ask that providers who submit an electronic claim and also submit a paper attachment for that claim to use these fields. When sending UUHP an attachment, please verify that the identification number that was provided in the electronic file is also on the attachment so we can identify the claim the attachment belongs to. We will pend all claims that you have indicated have an attachment until we have received the attachment. You can find more information about attachments on page 214 of the Professional Implementation Guide and page 173 of the Institutional Implementation Guide.
Corrected Claims
Corrected claims do not need to be dropped to paper, they can be submitted electronically. There are a few fields that need to submitted in the 4010 837 to indicate that the claim is a correction.
Claim frequency type code on page 173 of the Professional Implementation Guide and page 159 of the Institutional Implementation Guide.
Claim original reference number on page 229 of the Professional Implementation Guide and page 191 of the Institutional Implementation Guide.
If corrected claims are submitted without a claim frequency type code indicating it is a correction and the claim original reference number, our claims processing system will automatically deny the claim as a duplicate.
Notes
Claim notes, claim line notes (professional claims only) and claim billing notes (institutional claims only) can be submitted in the electronic file. UUHP will not know if the claim note(s) affect the claim payment, therefore UUHP will pend any claims with claim notes for review. If the notes you are submitting do not affect claim payment the claims will take longer to process as they will require manual review, so we ask that you limit claim notes to only information such as:
- Accident details
- Auto or subrogation detail
- Any special circumstances
You can find more information about claim and claim line notes on page 246 and page 488 of the Professional Implementation Guide. You can find more information about claim notes and claim billing notes on page 205 and page 208 of the Institutional Implementation Guide.