Claim Cancellation
Published: February 29, 2024
Last updated: February 29, 2024
Claim Cancellation
Cancelling a claim is only available for claims previously accepted by the MCO, indicated by successful processing of both EDI 999 and EDI 277 forms. Rejected forms mean the claim wasn't received, and no action is needed.
A detailed note must be added, explaining the reason for the claim cancellation. This note is critical as it is reviewed by the insurance company.
You will need the reference number from the ERA. If Ambiki has received the ERA directly, the interface would provide this for you. If the ERA was mailed to you, you will need to provide the reference number.
To cancel a claim, ensure you are logged in to Ambiki and on the main dashboard:
- On the left navigation, click on ‘Patients’.
2. Select the patient for the claim cancellation by clicking on their name.
3. Select ‘Payments’ at the top of the patient profile page.
4. Scroll down to the ‘Patient treatment reports’ section.
5. Click on the treatment report for the claim that needs to be corrected.
6. Click on ‘Invoice actions’ and select ‘Correct claim’. **‘Correct claim’ will only be available if both the EDI 999 and EDI 277 have been ‘Accepted’.
7. Fill in the claim correction form taking care to choose ‘Cancellation’ as the correction type. **Ensure you have added a claim note and a reference number. Once finished, click on the button labelled ‘Review changes’.
8. Review your changes and click on the button labelled ‘Cancel claim’.
Samuel Okoth