Medicaid claims may be replaced directly from Barnestorm. Each Medicaid claim sent for each patient has a unique identifying number, called an ICN. An ICN is a 15-digit number that uniquely identifies one payment of one claim (NC Medicaid).

You need to create a replacement claim when the original claim that was transmitted was incorrect due to missing information or incorrect information (examples: the claim did not include a visit that was added to the system after the claim was sent, or the number of hours billed was incorrect).

• IMPORTANT: if the claim rejected and did not pay, then just build a new claim and send it--replacement is not needed when the claim doesn't pay at all.

• NOTE:  These same steps can also be done for other payers (Medicare, HMOs, BCBS etc); however, the ICN/DCN format may be different dependent on the payer.  Some payers may simply call this the "claim number."

Here are the steps to locate/manually enter the ICN/DCN/Claim Number required for all Replacement Claims:

 Verify ICN Information 

• Go to Accounts Receivable > ICN Edit.
• Enter the patient's chart number.
• If the patient has more than one payer, select the payer.
• The ICNs are listed on the right, showing From Date, Through Date, Paid Date, and ICN number. Determine which ICN needs to be replaced based on the dates. Make a note of the from and through dates.
• If the dates you need to replace are NOT listed, follow steps below.

If the ICN you need to replace is not there, you can enter it manually using these steps:

1. Click the Add a New ICN Entry line.
2. Enter the information from your paper copy of the remittance advice: payment date, from date, through date, and ICN number.
3. Click the Save button.
4. Your ICN entry will now appear in the list; make a note of the from and through dates and continue the steps in this process.

 Create Replacement Claim

 The 837 file has information regarding the UB04 claim:

 on the line starting CLM* , after the :: there is a number--

1 = original claim

7 = replacement claim (If there is no “7” then you have not created a replacement claim.)

8= void claim

 line after the CLM* has the ICN number

On the claim, itself, the TOB will show 0327 (top right corner of claim).

The 837 file has information regarding the CMS1500 claim:

• On the line starting CLM* , after the :: there is a number--

 1 = original claim

 7 = replacement claim (If there is no “7” then you have not created a replacement claim.)

 8= void claim

• Only with a replacement claim will the following line appear in the 837 file.  This line appears after the "CLM" line.  Here is an example of what it will look like:

REF*F8*1234567890 (represents the ICN#)

• On the claim, itself, the number 7 (or 8 if it's a void claim) and the ICN# will appear on the line beneath the ICD codes.