Welcome, Brokers!

To support accurate and timely claims processing, providers are reminded not to submit a corrected claim until the original claim has completed processing and reached a finalized status.

When a corrected claim is submitted for a claim that has not yet finalized, the submission will be rejected with code 6U – Unfinalized claim; replacement cannot be accepted. This rejection is intended to prevent duplicate or conflicting claim activity while the original claim is still under review in process.

What Providers Need to Know

• Wait for the original claim to finalize before submitting a corrected claim.
• Corrected claims submitted before the original claim is finalized will be rejected with code 6U.
• Once the original claim has finalized, providers may submit a corrected claim following the organization's established corrected claim procedures.

Avoid Delays

Submitting corrected claims too early can result in unnecessary rework and processing delays. Before submitting a correction, verify the status of the original claim through the Fidelis Care Provider Portal (Provider Access Online – PAO) or your applicable claims inquiry process.

Follow the Corrected Claim Guidelines

Providers should continue to follow the Corrected Claim Guidelines outlined in the Provider Manual, including the appropriate submission requirements and claim indicators. Adhering to these guidelines helps ensure claims are processed accurately and efficiently.