MedicaidAdministrativeMedium impact
Clarification on Submitted Corrected Claims
L.A. Care Health Plan·CA·Provider Communication
We identified it
Jun 20, 2026
Summary
L.A. Care Health Plan has clarified requirements for submitting corrected claims, specifying that providers must include the exact L.A. Care claim number (including suffixes like A1) and use specific billing codes and forms. Corrected claims must be submitted within 365 days of initial determination and include all previously billed line items.
Action Required
Immediately: Billing team must update corrected claim submission procedures for L.A. Care claims. Ensure staff stamp 'Corrected Claim Billing' on CMS-1500 forms, use billing code '7' in box 22, include original claim number with exact suffix (like A1) in Plan CRN field, and submit all previously billed line items. For UB04 forms, use '7' as fourth digit in Type of Bill field. For EDI submissions, use frequency code '7' and include F8 reference segments. Train staff on 365-day submission deadline from initial determination date.