Voiding

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• Voiding
• MaineCare
• Claims

Caring.. Responsive.. Well-Managed.. We are DHHS
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• Topics
• 1. Definition of a void
• 2. When and how to void claim document or claim
  line
• 3. When and how to use the void/re-bill
  workaround
• 4. Remittance advice changes
• 5. Risks and how to minimize them

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What is a VOID?

• A void is the complete reversal of a claim
  document or claim line.
• Only Paid/RA Generated claim documents or claim
  lines can be voided.
• Never void a denied claim document or claim line
• Never void a voided claim document or claim line
• Never void an adjusted claim document or claim
  line
• Never void a claim at the document level that has
  a denied line. Void at the line level for the
  paid lines and re-bill denied lines.
• Never void line level claims with Room and Board,
  Cost of Care, Spend-down and Third Party
  Liability for Provider Type 31. Must void at the
  document level and must have all lines paid on
  the original document.
• Contact your Adjuster if you need to void a claim
  with Room and Board, Cost of Care, Spend-down or
  Third Party Liability and cannot void at the
  document level due to denied lines on the
  original claim.

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What claims can be voided?

• Claims paid
• with incorrect member information
• to the wrong provider
• wrong procedure code
• more than once
• claims that should not have been billed to
  MaineCare

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Void/Re-bill workaround

• A workaround has been developed for providers who
  do not want to wait for the replace
  functionality to submit adjustments. It is a
  two step process called void/re-bill
  workaround.
• A Void/Re-bill is the resubmission of charges
  following the receipt a Remittance Advice (RA)
  confirming that the Void processed successfully.

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When to use the void/re-bill workaround

• Void/re-bill workaround can be used for claims
  paid
• At 0 (since you were paid 0, we will withhold
  0 when the void processes successfully to an RA)
• for wrong amount of units
• for wrong dates of service
• with wrong cost of care applied
• the entire amount paid on the original claim
  will be withheld from
• paying claims when the void processes
  successfully to an RA)

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When NOT to void a claim

• Dont void a claim with the intent to re-bill
  when
• - the system is not paying your current claims
  correctly (submitting a void will
• not fix current system issues)
• - the claim was used to determine cost
  settlement (the rate change was
• considered when the cost settlement was
  done)
• - the claim has been denied (you cannot void
  a denied claim document or claim
• line)
• - the claim is not Paid/RA Generated (The
  claim must be paid and have
• processed to an RA before you can void)
• Hospital providers should submit all voids even
  if cost settled

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How to use the Void/Re-bill workaround

• - Submit a Void for a Paid/RA Generated claim
  document or claim line
• Wait until the Void processes successfully to an
  RA
• - Re-bill the claim with any corrections
  necessary

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What Happens Next?

• When the void processes successfully to an RA,
  the entire amount of void will be
  subtracted from paying claims. If there is not
  enough paying claims on that RA, the balance will
  be carried over to the next RA.

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What is a TCN?

• Transaction Control Number (TCN)
• Each claim received at the Office of MaineCare
  Services is stamped with a TCN number. Current
  TCNs are 18 digits long.
• Document/Header level TCNs end in 000
• Example 002006147084063000
• Line TCNs end in 001, 002, etc.
• Example002006147084063001

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HCFA 1500 or CMS 1500 document level void

• Enter 8 in box 22 in the space for Medicaid
  Resubmission Code and enter
• the Original TCN in the space Original Ref. No.
• To void an entire claim, use the header TCN
  that ends in 000
• 22. Medicaid Resubmission
• Code Original Ref.
  No.
• 8
  002007090060016000
• All lines submitted on the original claim must be
  reported on the void claim when voiding at the
  document level.

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HCFA 1500 document level void example
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CMS1500 document level void example
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HCFA 1500 or CMS 1500 line level void

• To void a single claim line, use the line TCN
  from the
• original claim
• 22. Medicaid Resubmission
• Code Original
  Ref. No.
• 8
  002007090060016001
• Only the line information submitted on the
  original claim must be reported on the void claim
  for a line level void.

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HCFA1500 line level void example
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CMS1500 line level void example
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UB 92 document level void

• Enter 8 for the last digit in FL 04 and the TCN
  in FL 37 A
• To void an entire claim, use the header TCN
  that ends in 000
• FL 04 Type of Bill 0348 FL 37 A
  002006115643030000
• The first three digits in FL 04 will always be
  the same two or three digits you normally use
  when billing claims. This example is for a Home
  Health claim. The 8 designates the Void.
  MaineCare currently accepts 3 or 4 digits in FL04
  for UB 92 claims.

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UB 92 document level void example
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UB 92 line level void

• To void a single claim line, use the line TCN
  from the original claim
• Enter 8 for the last digit in FL 04 and the TCN
  in FL 37 A
• FL 04 Type of Bill 0348 FL 37 A
  002006115643030001
• The first two or three digits in FL 04 will
  always be the same three digits you normally use
  when billing claims. This example is for a Home
  Health claim. The 8 designates the Void.
  MaineCare currently accepts 3 or 4 digits in FL04
  for UB 92 claims.
• Only the line information submitted on the
  original claim must be reported on the void claim
  for a line level void.

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UB92 line level void example
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UB 04 document level void

• Enter 8 for the fourth digit in FL 04 and the TCN
  in FL 64 A
• To void an entire claim, use the header TCN
  that ends in 000
• FL 04 Type of Bill 0348
  FL 64 A
• 
  002006115643030000
• The first three digits in FL 04 will always be
  the same three digits you normally use when
  billing claims. This example shows
• First digit 0
• Second digit 3 (Home Health)
• Third digit 4 (Other Home Health)
• Fourth digit 8 (Void)

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UB 04 (FL04)
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UB04 (FL64A)
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UB04 line level void

• To void a single claim line, use the line TCN
  that will end in the line number of the original
  claim
• FL 04 Type of Bill 0348
  FL 64 A 002006115643030001
• The first three digits in FL 04 will always be
  the same three digits you normally use when
  billing claims. This example shows
• First digit 0
• Second digit 3 (Home Health)
• Third digit 4 (Other Home Health)
• Fourth digit 8 (Void)
• Only the line information submitted on the
  original claim must be reported on the void claim
  for a line level void.

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UB 04 line level void example (FL04)
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UB 04 line level void example (FL64A)
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Dental Claim 1999 version 2000 document level void

• 8 and TCN in Box 61
• To void an entire claim, use the header TCN
  that ends in 000
• 61. Remarks for unusual services
• 8 002006147084063000

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Dental document level void example
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Dental line level void

• To void a single claim line, use the line TCN
  that will end in the line number of the original
  claim.
• 61. Remarks for unusual services
• 8 002006147084063001
• Only the line information submitted on the
  original claim must be reported on the void claim
  for a line level void.

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Dental line level void example
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Electronic HCFA 1500 and Dental claims

• HCFA 1500 and Dental Claim
• Submission Reason Code and Original TCN are
  located in Record G
• Enter the 8 field number 5, position 41
• Enter the Original TCN in field number 6,
  position 42
• Record G only needs to exist if you are
  attempting to void a claim. Otherwise, this
  record may be left off the claim.

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Electronic Institutional claims (UB92)

• Enter frequency code 8 in record type 10, field
  number 2, type of batch
• Field number 2 consists of three segments. The
  third segment is reserved for the frequency code.
  This is position 5.
• Enter the Original TCN in record type 31, field
  number 14, form locator 37
• Field number 14 begins at position 155 and is 23
  characters in length. The TCN is 18 characters.
  Therefore, this field is left justified and the
  remaining 5 characters will be blank.
• Record type 31 only needs to exist if you are
  attempting to void a claim. Otherwise, this
  record may be left off the claim.

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RA Changes

• RA Changes
• TPL Amount and Member Responsibility Amount
  columns removed
• Adjustment Source and Offset Indicator columns
  added
• New Denied Adjustment category
• Codes 96 (Billed amount) and 129 (Paid amount)
  will always be present for Voids
• TPL will be reported under Adjustment reason code
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• Member Responsibility amount will be reported
  under Adjustment reason code 142 and will include
  Patient Liability, Patient Paid and Spend-down
  Amounts. (this may present posting problems for
  providers who post directly from the 835)

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Remark Codes
Remark Code What it means
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Adjustments
Adjustment What it means
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Risks and how to minimize them

• Entire amount of void claim will be withheld from
  current paying claims.
• -Providers with tight budgets will want to
  submit voids carefully so as not to
• cause any hardship when the void is
  processed and money withheld from
• claims payments.
• Claims with dates of service prior to 7/01/2007
  will be held for interim payment
• payback for providers with interim payment
  balances.
• Submit small batches of void claims to see if
  they process correctly

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Claims Portal

• The claims portal will not display the words Void
  or Credit. Instead the number 73 and/or 76 will
  be displayed.
• 73Void
• 76Credit
• The Interactive Voice Response (IVR) cannot give
  claims status for void or credits.
• Claims portal link
• https//portalx.bisoex.state.me.us/jav/DHHSClaimSt
  atus_prod/requestStatus.jsp

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Other useful links

• MaineCare website
• http//www.maine.gov/dhhs/bms/
• News You Can Use
• http//www.maine.gov/dhhs/bms/member/innerthird/me
  cms_portal_news.html
• MeCMS void functionality instructions
• http//www.maine.gov/dhhs/bms/pdfs_doc/mecms/news_
  can_use/provider_instructions_voids_final_20070927
  .doc

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• Questions? Call 1-800 321-5557 Option 8

Caring.. Responsive.. Well-Managed.. We are DHHS