Corrected (Replacement) and Voided Claim Requests
When submitting a request for a corrected (replacement) or voided claim, Neighborhood requires data to be populated in Field 64 on a UB-04 (Institutional) claim form, or in Field 22 on a CMS-1500 (Professional) claim form. Corrected (replacement)/voided claims submitted without this information will be rejected and returned to the sender. Please visit the “Claim Forms” section of the Provider Manual & Newsletter page on our website to obtain the revised Corrected (Replacement)/Voided Claim Request Form, now available for use. Continued use of an outdated form will cause your request to be returned to you.
Check Submission for Overpayments
Please do not send unsolicited checks to Neighborhood for overpaid claims. The best practice is to let affected claims systematically readjudicate and appear as a credit balance on an issued remittance advice. Auto-adjudication or the proper submission of a corrected/replacement claim is the compliant way to receive payment.