As of May 1, 2011, institutional claim corrections will not require a completed provider inquiry form. Simply file the corrected claim electronically using one of the following as the final digit of the claim’s type of bill on the 837 Institutional transmission:

5    Late Charges Only Claim

6    Adjustment of Prior Claim

7    Replacement of Prior Claim

8    Void/Cancel of Prior Claim

Note:

• The type of bill must be appropriate to the claim and the change. For example, the final digit of “5” means late charges only; no other charges can be listed on the claim.
• Claims originally submitted on paper may be corrected electronically.
• Corrected claims submitted on paper continue to require a completed provider inquiry form.