Avoid claim rejections and denials

Reasons why corrected, duplicate and multiple claims are rejected

Effective April 1, 2025, we will enforce CMS and health plan guidelines by rejecting or denying the following types of claims:

• Multiple new claim submissions for the same date of service
  Submit 1 claim for all services rendered on the same date(s) of service by the same health care provider for an individual member. If you submit multiple original claims for the same date(s) of service, the original submission will adjudicate, and the system will reject the subsequent claims and request a corrected claim.
• Corrected claims with missing or incorrect information
  When making changes to a claim, the corrected claim replaces the original. The original claim is no longer valid. To avoid corrected claims from being rejected, apply the following tips:
  • Allow the original claim to be adjudicated prior to submitting a correction
  • Include all originally billed services rendered to the member by the individual health care provider, not just the line you’re correcting. Failure to submit all previous billed services on a corrected claim will result in an overpayment recovery of the excluded services.
  • Code the claim with the frequency code “7” and the original claim number
• Duplicate claims with identical service codes and dates of services
  • If you haven’t received payment within the standard processing time, check the claim status before resubmitting a new one. Resubmitting a claim while the original claim is being adjudicated may create a duplicate claim, which the system will reject. This may further delay processing and payment.
  • If your claim has already been adjudicated, you can submit changes to your billing on a corrected claim
  • If you disagree with the processing outcome, you can request a claim reconsideration. View our Online Reconsiderations and Appeals/Disputes interactive guide to learn more.

What this means for you

When the system rejects a claim, you’ll need to make the necessary changes and submit a corrected claim. Help ensure correct processing of your claim and avoid rejections for duplicate claims by applying the following procedures: 

• Submit 1 claim listing all services rendered by an individual provider on the same date(s) of service 
• Use modifiers and/or units when appropriate to identify separate and distinct services
• Allow claims to process before modifying an original claim with a corrected claim

How to submit a corrected claim

You can bill corrected professional and institutional/facility claims using any of the following methods:

• Electronic Data Interchange (EDI)
  • Enter frequency code/bill type “7” into the 2300 Loop CLM05-03
  • Include the Original Reference Number (claim identifier) in REF02 segment
• UnitedHealthcare Provider Portal
  • Sign in to the portal using your One Healthcare ID and password
  • Select the Claims & Payments > Act on a Claim > Submit corrected claim
  • For detailed instructions, visit our Claims Interactive Guide
• Paper claims
  • Enter frequency code “7” in box 22, in the left-justified position
  • Include the original claim number in the Original Reference Number box

Submitting corrected claims through the UnitedHealthcare Provider portal is a fast and easy solution that provides quick results. New users who don’t have a One Healthcare ID can visit UHCprovider.com/access to get started