Review and resubmit claims

You can review, revise, and resubmit claims in the Stedi portal. This includes professional claims you submitted through the portal as well as professional, dental, and institutional claims third-party vendors submitted through Stedi on your behalf.

Find specific claims

The Transactions page shows all submitted 837 claims, 277CA claim acknowledgments, and 835 Electronic Remittance Advice (ERA) responses.

Click Filters to narrow the list to specific claims. We recommend the following filters:

Filter	Description
Search term	We recommend entering the claim's Patient Control Number (Loop 2300 CLM01) if it's unique for each claim. This will help you find the specific claim you're looking for. If you don't have the Patient Control Number, you can search for another identifier, such as the patient's member ID or last name, to help narrow down the results. The search term must match what's in the claim exactly, including all spaces, capitalization, and punctuation.
Date processed	This is the date Stedi received the claim, not the date of service. Make sure you select the correct Time zone at the bottom of the filter.
Transaction	Select 837 Health Care Claim to filter for only submitted claims. Stedi will show all claim types - professional, dental, and institutional (if present) in the filtered list.

Once you find the transaction you want to review or resubmit, click it to open its details page.

Revise and resubmit claims

You may need to resubmit claims for several reasons, including changes to the patient's coverage, errors in the original claim's information, or appealing a denied claim. You may also need to cancel duplicate claims or claims that were submitted in error.

You can manually revise and resubmit professional, dental, and institutional claims in your account. To manually resubmit a claim:

1. Go to the details page for the claim you want to resubmit.
2. Click Edit and resubmit. Stedi opens the claim in an interactive editor with the X12 EDI on the left and the EDI specification on the right. As you hover over different parts of the EDI, Stedi highlights the corresponding part of the specification in the Inspector tab to help you understand what each part of the EDI means and how to edit it correctly.
3. Make any necessary changes to the claim EDI.
   • You can type directly in the EDI editor or copy and paste updated EDI from another source. Make sure to update the Claim Frequency Code, Payer Claim Control Number, and Patient Control Number according to best practices.
   • You can switch to the Reference transactions tab to review related 277CAs containing the errors you need to address before resubmitting. Click a transaction to review its details.
4. Click Review and submit. Stedi shows a comparison of the original claim and the new claim containing your changes.
5. Click Resubmit claim to send the updated claim to the payer.

Stedi validates the updated claim and submits it to the payer. It will appear on the Transactions page as a new 837 claim. You will also receive new 277CA claim acknowledgments indicating whether the resubmitted claim was accepted or rejected.

Claim Frequency Code

Set the Claim Frequency Code to one of the following values. In X12 EDI, this is the Loop 2300 CLM05-03 (Claim Frequency Code) component.

• Resubmit to Stedi or another payer: Set to 1 - Admit thru Discharge Claim. Either Stedi rejected the claim due to validation errors, or you're resubmitting the claim to a different payer for the first time. In either case, the payer hasn't yet processed the claim.
• Correct or replace claims: Set to 7 - Replacement of Prior Claim. In this case, the payer processed the original claim.
• Cancel claims: Set to 8 - Void/Cancel of Prior Claim.

Payer Claim Control Number

When correcting, replacing, or canceling claims, you should include the Payer Claim Control Number (sometimes called the ICN) from the original claim for identification. In X12 EDI, this is Loop 2300 REF02, where REF01 = F8 (Original Reference Number).

• The Payer Claim Control Number is different from the value you sent in the original claim's Loop 2300 CLM01 (Patient Control Number).
• You can retrieve the Payer Claim Control Number from one of the payer's 277CA claim acknowledgments in Loop 2200D REF02 when REF01 is set to 1K (Payor's Claim Number).

Patient Control Number

When correcting or replacing claims, we also recommend setting a new, unique Patient Control Number. In X12 EDI, this is the Loop 2300 CLM01 element. The payer includes this value in their 835 ERA, allowing you to easily correlate that response with your resubmission.

Claim details

The claim's details page shows an overview of the claim, including the patient, provider, and service information.

Related transactions

In the Related transactions tab, you can find links to all related transactions, such as 277CA claim acknowledgments and 835 Electronic Remittance Advice (ERAs).

Download X12 EDI

You can review and download the raw X12 EDI for any 837 claim in your account.

To download the EDI for a claim:

1. Go to the Transactions page and click the claim response you want to download.
2. Go to the X12 tab. The EDI is displayed on the right and the specification is displayed on the left. As you hover over different parts of the EDI, Stedi highlights the corresponding part of the specification to help you understand what each part of the EDI means.
3. Click the download button (down arrow icon) at the top left of the EDI viewer to download the transaction as an .edi file.