NEW Claim Fix in Aloha
As of July 2025, The ALOHA Fix Claim process is now located in AR Manager for a more streamlined workflow. The former claim fix section will be removed from AlohaABA on September 1, 2025. Any claims not fixed and rebilled by then will need to be reinitiated using the new Fix Claim feature in AR Manager outlined below.
You are still able to fix claims directly in the clearinghouse or payer portal.
Before we get started, let’s define these words:
Rejection: When a claim is rejected, the claim must be fixed so that it goes through to the payer. A rejected claim means that it got stuck in the clearinghouse (OA) due to a clerical or demographic error, and has to be addressed before the payer receives it. Sometimes a claim is accepted by the clearinghouse and then rejected by the payer before a claim number is created for it. This should still be treated as a rejection rather than a denial.
Denial: When a claim is denied, needs to be edited after submitting and has been received already, or voided, then it needs to be corrected. A denied claim has been received by the payer and denied for whatever reason, and needs to be addressed before resubmitting for reconsideration.
Claim Correction due to a Mistake: If you realize you made a mistake on a claim that wasn't denied or rejected by the payer, it's still important to do a claim correction.
Rejections:
1. Navigate to Billing > AR Manager and double click on the Payer who's claim you need to fix.
2. Click the 
button next to the claim you need to fix.
3. You will now see your claim as it is shown on the CMS1500.
4. Make any changes you require in your claim. For example, you may need to update the subscriber ID or a provider's NPI. The reason for rejection will be provided by the payer or clearinghouse.
5. The resubmission code in box 22 should be 1. There should be nothing written in the box next to it, "original reference number".
5. Click SUBMIT CLAIM at the bottom of the screen.
For rejections, it is not necessary use box 19 or 22 on the CMS 1500. Since a claim number was never created, this will be treated as a new claim, not a rejected claim. The resubmission code should be 1. There is no original reference number.
Denials (or if you realize you made an error):
Please follow these steps to complete a claim fix in Aloha:
1. Navigate to Billing > AR Manager and double click on the Payer who's claim you need to fix.
2. Click the button next to the claim you need to fix.
3. You will now see your claim as it is shown on the CMS1500.
4. Make any changes you require in your claim. In this example, we added modifiers to the claim.
5. In Box 19, write a brief description of how you fixed the claim.
6. In Box 22, change the resubmission code.
Guide to resubmission codes:
1- Original Claim
7- Replacement Claim
8- Void Claim
7. Write the original reference number in box to the right of Box 22.
This is the payer claim control number found on your ERA.
8. Click SUBMIT CLAIM at the bottom of the screen.
9. Back in AR Manager, you can access your claim by clicking on the transaction log and then the hyperlink to the claim. This will enable you to view your CMS1500 and download or print if needed.
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