How do I cancel or resubmit a Claims API request?

Last Updated May 23rd, 2017

Claims files are batched and sent at 5 minute intervals.  If the request to cancel the API request occurs within the 5 minute grace period and the activity is still in a scheduled state, you can submit a PUT to the Activities API for the activity id in question.  If the file has already been sent to the trading partner and requires a void/cancellation, there are two parameters that need to be updated and submitted on the follow up Claims request.  You will need to update the claim.claim_frequency parameter to a value of “cancel” as well as sending the payer claim control number in the claim.original_reference_number field.  The same process should be followed for a resubmission with the exception that the claim_frequency parameter to be used is “corrected”.  The payer claim control number can be located in the response file for the original claim under patient.claim_level_info.claim_control_number when returned by the payer.  If this field is not returned, the patient.claim_level_info.tracking_id or patient.claim_level_info.claim_id_number value can be used.


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