Void & replace

Outcome

A claim that was accepted and paid but contains an error is properly voided (frequency code 8) or replaced (frequency code 7) on the payer side, the new claim is submitted, and the AR/COB ledger reconciles.

Prerequisites

Scope	What it lets you do
billing.claim.write	Issue void / replace
billing.payment.read	See the original 835
billing.payment.write	Reverse a posted payment, if needed

The original claim is ACCEPTED at minimum and usually PAID or PARTIAL. Void/replace is for post-acceptance fixes; pre-acceptance fixes use 3.3 — Rebill & correct.

The two flavors

Frequency code	What it tells the payer
7 — Replacement	"Forget what I sent before; here's the corrected version."
8 — Void / cancel	"Void what I sent before; this is not a replacement."

The platform sets the frequency code on the 837's CLM05-3 element. You don't write it by hand — the Replace claim and Void claim buttons do.

When to use each

Scenario	Use
Wrong unit count on a paid claim	Replace (freq 7).
Billed wrong member	Void original (freq 8); new claim under correct member.
Wrong CPT but right service	Replace.
Service didn't happen at all	Void.
Duplicate of another paid claim	Void the duplicate.

Steps — Replace

1. Open the original claim. Click Replace claim. The platform:

   • Reverses the original's pricing.
   • Unlocks attached charges.
   • Opens an Edit charges view.

2. Edit the charges to the correct values. See 2.6 — Edit / correct a charge.

3. Click Build replacement. The platform builds a new claim with:

   • parent_claim_id = original.
   • original_payer_icn = the 277CA's ICN of the original.
   • Frequency code 7 on submit.

4. Submit per 3.1. The new claim goes out; the payer reverses the original's payment and applies the new adjudication. You'll see this on the next 835.

Steps — Void

1. Open the original claim. Click Void claim.

2. Confirm reason (required). Common reasons: wrong member, service did not happen, duplicate of <other claim>.

3. Click Submit void. The platform builds and submits a void claim (freq 8) referencing the original's ICN. No new claim follows.

4. Reconcile the payment. The next 835 will reverse the original payment with CAS*CO*45 (or similar) and zero-pay. The receivable flow handles it; you don't need to manually reverse the prior posting.

When the payer rejects a void / replace

Some payers refuse to accept frequency 7/8 for certain transaction types or after a payer-defined time window:

Reject pattern	Move
277CA: A7 "Original ICN not found"	The payer's ICN reference is wrong; cross-check the original's Submission 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 requires an appeal with documentation.

Validation

Check	Expected
Replace creates a new claim with parent_claim_id	Yes.
Void does not create a new claim	Correct.
Original's status moves to VOIDED (after void) or REBILLED (after replace)	Yes.
Posted payment on original reverses on the next 835	Yes; receivable picks it up.
Member's AR balance updates after the reversal posts	Yes.

Troubleshooting

Symptom	Cause	Fix
Replace greyed	Claim isn't ACCEPTED or beyond	Use 3.3 — Rebill instead.
Replacement claim duplicates payment	Payer didn't reverse on receipt	Open a 276 inquiry; some payers process replacements as new claims.
Void's reversal CAS is for the wrong amount	Payer applied a different adjustment than expected	File a follow-up appeal or accept and update the COB ladder.
Member's AR doubles after replace	Both original and replacement showing as outstanding	Check the receivable; the original payment reversal may not have posted.

Where to next

• 4.1 — ERA inbox for posting the reversal and replacement payment.
• 5.5 — File an appeal when the payer refuses the void / replace.