ForwardHealth Portal 837 Claims Adjustments
The Wisconsin Department of Health Services (DHS) is providing updated guidance to Children's Long-Term Support (CLTS) providers regarding adjusting claims originally processed by Wisconsin Physicians Service (WPS). Providers may submit adjustments for these claims using either a paper claim adjustment or an 837 transaction through the ForwardHealth Portal. Adjustments via 837 are permitted for all claims processed by WPS, regardless of whether the original submission was in 837 format.
What is an 837 health care claim?
The 837 file is a Health Insurance Portability and Accountability Act (HIPAA)-compliant electronic document used to communicate health care claims to insurers. This electronic format replaces traditional paper claims, streamlining the billing process and improving efficiency in transactions.
Claim adjustments using an 837 transaction
Providers can use ForwardHealth to submit adjustments to claims that were processed by WPS using the 837 transaction method. Using the 837 transaction method will result in faster claim processing and adjudication. The following information must be included in the file for each adjustment:
- 2300 REF*F8*WPS CLAIM NUMBER TO ADJUST
- 2300 REF*G1*Applicable ForwardHealth prior authorization (PA) number
- 2300 CLM (05-03) 7 (adjustment) or 8 (void)
All other applicable data requirements for a valid submission must be included for adjustments to be submitted. The 837 Health Companion Guide, P-00265 (PDF) and the 837I Companion Guide, P-00266 (PDF) can provide additional information required on 837 claims forms.
Have questions or need help?
If you have questions or need help, please contact the CLTS Operations Team at cltsoperations@gainwelltechnologies.com or 844-942-5870.
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