www.mercycareplan.com                                  www.mercymaricopa.org
April 6, 2018
Void Requests
As you are aware, a request to void a claim can be accomplished by submitting the following: 
  
UB-04 - Enter Bill Type (Field 4) of 8 = Void/Cancel of Prior Claim as the last digit of this 4 digit field.  
CMS 1500 - (Field 22) of  8 = Void/Cancel of Prior Claim.
 
 
While this is standard billing practice, Mercy Care Plan and Mercy Maricopa experienced some difficulties with these types of claims where the claim would be voided, per request, however, it was then reprocessed and paid again.  In the past we resolved this issue by having providers submit these claims on a spreadsheet so that we could assure the claim did not get reprocessed again. 
 
We wanted to let you know that we have resolved this issue and spreadsheets are no longer necessary to submit in order to get these void requests completed.  If we receive a spreadsheet, we will void the claims listed, however, submitting the claim per industry standard will streamline the process for you. 
 
As always, don't hesitate to contact your Mercy Care  or your Mercy Maricopa Provider Relations Representative with any questions or comments. You can find this notice and all other provider notices on our Mercy Care Plan or Mercy Maricopa website.   

Thanks for all you do!


www.mercycareplan.com                        www.mercymaricopa.org