Void & replace
Outcome
A claim the payer has already decided (paid, reconciled or denied) but that contains an error is either replaced (an adjustment, frequency code 7) or voided with the payer (frequency code 8). A voided claim's services are then re-billed, when they should be, as a new original claim (frequency code 1), and the ledger reconciles from the payer's remittance.
Prerequisites
| Permission | What it lets you do |
|---|---|
claims.update | Adjust a claim; request, cancel or resend a payer void |
claims.create | Re-bill a closed void as a new claim |
config.update | Set a payer's Void charge |
The original claim is PAID, RECONCILED or DENIED, with a
remittance (835) matched to it. A claim the payer has not decided yet is fixed
with 3.3 — Rebill & correct, or withdrawn with
the plain Void button before it is sent.
The two flavors
| Frequency code | What it tells the payer | Button |
|---|---|---|
7 — Replacement | "Forget what I sent before; here's the corrected version." | Adjust |
8 — Void / cancel | "Reverse what I sent before and take back what you paid. Nothing replaces it." | Void with Payer |
The platform sets the frequency code on the 837's CLM05-3 element (the last
digit of the type of bill on an 837I) and the payer's claim number in
REF*F8. You don't write either by hand.
When to use each
| Scenario | Use |
|---|---|
| Wrong unit count or charge on a paid claim | Adjust (freq 7). |
| Wrong CPT but right service | Adjust. |
| Billed the wrong member or the wrong payer | Void with Payer (freq 8), then Re-bill as new claim once the charges are corrected. |
| Service didn't happen at all | Void with Payer; do not re-bill. |
| Duplicate of another paid claim | Void the duplicate with the payer. |
| Only some lines should not have been billed | Void with Payer → Only some lines. |
Steps — Adjust (replace)
See the in-app help Adjusting a paid, reconciled or denied claim. In short: open the claim, choose Adjust, change the header or lines, give a reason and save. The replacement is built at frequency 7 with the original's payer claim number, and the two claims link to each other.
Steps — Void with Payer
Open the original claim and choose Void with Payer in the header. It shows only on a Paid, Reconciled or Denied claim with a matched 835, no open void and no open adjustment, rebill or merge.
Choose the scope: the whole claim, or Only some lines (tick each line; each shows what the payer paid on it).
Enter a reason (required) and check the Expected takeback — what the payer paid on what you are voiding, $0.00 on a denied claim — and the payer's Void charge ($0.00 or $0.01 per voided line).
Choose
Request void. Nothing is removed and no money moves: the claim keeps its status and payment. The void is sent to the payer as a frequency-8 837 straight away, carrying only the voided lines at the payer's void charge. From now on Adjust and Rebill are not offered on the claim.
Follow the void — open void balance
The Payer void panel on the claim shows the void's status, Paid when voided, the Open void balance (the takeback still expected; $0.00 once closed), every frequency-8 send with its acknowledgment, and on a closed void the 835 check that closed it.
| Status | Means | Do |
|---|---|---|
| Void pending | Recorded, about to be sent | Nothing |
| Void sent | Waiting for the 999 / 277CA | Wait |
| Void accepted | The payer accepted; the takeback comes on a later 835 | Wait for the retro |
| Void closed | The payer took the money back | Re-bill as new claim if needed |
| Void rejected | The payer refused; the claim and its payment stand | Fix what the payer named, then Resend void |
| Void cancelled | Withdrawn before it was sent | Nothing |
Cancel void is offered only while the void is still waiting to be sent, which is rarely more than a moment. A sent or rejected void cannot be cancelled.
On the Claims list, the Payer Void filter's Open voids option lists every claim with a void that is pending (not yet sent, sent or accepted) or rejected, with a Void pending / Void rejected / Voided badge beside the status. Export writes the same rows with a Payer Void column.
The retro — how the money comes back
The payer answers the void on an 835, and posting applies it to the void:
| The payer | What happens |
|---|---|
| Takes back exactly what it paid on the voided claim or lines | The voided lines come to $0.00, the void closes, a whole-claim void moves the claim to VOIDED, and the voided charges are held for re-billing |
| Accepts a void with nothing to take back (a denied claim) | The void closes the same way; a 277CA accepting the void closes it too |
| Refuses the void | Nothing posts and the claim keeps its status. A Void Rejected denial opens on Denials & Appeals |
| Takes back a different amount | The 835 posts as usual, the void stays open with its open void balance, and a Void Takeback Mismatch exception appears on the remittance |
You don't reverse the earlier payment by hand; the retro does it.
When the payer rejects the void
The rejection shows on the void's send (999 / 277CA codes) or as a Void Rejected denial. Auto-correction never runs on it. Correct what the payer named, then choose Resend void on the claim: the void goes out again as a new frequency-8 837. Some payers refuse frequency 8 outright:
| Reject pattern | Move |
|---|---|
277CA: A7 "Original ICN not found" | The payer claim number is wrong or missing; check the claim's remittances and Submissions tab. |
A7 "Frequency code not allowed" | The payer requires a written adjustment request; see 5.5 — File an appeal. |
A7 "Outside adjustment window" | Payer-specific; usually needs an appeal with documentation. |
| Lines charged $0.00 rejected | Set the payer's Void charge to $0.01 (Configuration → Payers → the payer → Edit details). It applies to voids requested afterwards; a void already requested keeps the charge it was requested with, even when resent. |
Re-bill after the void closes
When a void closes, the charges it covered are held. Choose Re-bill as
new claim on the closed void to build them — and only them — into a new
original claim (frequency 1, no REF*F8): every charge for a whole-claim
void, the voided lines' charges for a lines void. Correct the charges first
(member, provider, payer) if that is why you voided.
- The new claim starts at Built; scrub and submit it per 3.1. It shows the Rebill correction type and is linked from the void's Re-billed as.
- The voided claim's lines, remittances and ledger do not change.
- Re-billing twice builds nothing new. A charge that cannot be built stays held, with the reason shown; fix it and re-bill again.
Validation
| Check | Expected |
|---|---|
| Requesting a void changes the claim's status or money | No — only the 835 retro moves money. |
The void 837 carries frequency 8, REF*F8 and only the voided lines | Yes. |
A whole-claim void moves the claim to VOIDED when it closes | Yes; a lines void leaves the claim's status as it was. |
Re-bill builds a frequency-1 claim with no REF*F8 | Yes. |
| The member's AR updates after the retro posts | Yes. |
Troubleshooting
| Symptom | Cause | Fix |
|---|---|---|
| No Void with Payer button | The claim isn't Paid, Reconciled or Denied, has no matched 835, or already has an open void or correction | Work the open void or correction first. |
| No Adjust or Rebill on the claim | It has a payer void that was not cancelled | Expected: the payer is removing the original claim. Re-bill after the void closes. |
| Cancel void says the void can no longer be cancelled | It was already sent | Let the payer answer it. |
| The void stays open after the takeback posted | The payer took back a different amount | Work the Void Takeback Mismatch exception. |
| Re-bill as new claim is missing | The void is not closed, or its charges were already re-billed | Wait for the retro, or follow Re-billed as. |
Where to next
- 4.1 — ERA inbox for posting the retro.
- 5.5 — File an appeal when the payer refuses the void.