Corrected Claims - Quick Reference Guide

Instructions for the Submission of Corrected Claims

If a provider has submitted a claim with incorrect or missing information (missing provider NPIs, submission of COB information, procedure, DRG or diagnosis codes, unit values, etc.), Sunflower Health Plan requires that providers submit a Corrected Claim. 

Timely Filing of Claims vs Timely Correction of Claims

  • First-time claims must be received by Sunflower within 180 calendar days from the date of service (discharge date for inpatient or observation claims).
  • When Sunflower is the secondary payer, claims must be received within 180 calendar days from the date of disposition (final determination) of the primary payer.
  • Corrected Claims must be received within 365 days of the date of Sunflower's notification of payment or denial.

Please contact your provider network specialist if you are interested in training to use our secure provider Portal.