Charge correction requests

How do we capture a department's charge correction with its reason, get it approved, and post it before the claim goes out, with overpayments returned within the rules?

Make the correction a reasoned request with an approver and a clock. When a department finds a charge error (a missed charge, a duplicate, a wrong quantity or code, a charge on the wrong encounter or patient, a supply charged without the procedure), Callvu prefills the encounter, the charges and the claim status from the billing system, captures the correction and the reason from the department in structured form with the evidence (the order, the medication administration record, the procedure log), classifies the correction (an add, a delete, a change, a transfer) and its billing effect (before the claim, a corrected claim, a refund of an overpayment), routes it to the revenue integrity approver in the Decision Desk by type and amount with only the allowed outcomes, posts the approved correction to the billing system, holds or corrects the claim, and starts the overpayment return where a paid claim was overbilled, within the sixty-day rule.

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Last updated November 7, 2026.

The problem today

The duplicate charge was found in a department spreadsheet, corrected by email, and the claim had already paid twice.

Today, without Callvu

Charges flow from clinical systems to the bill through the charge description master, and errors flow with them: a procedure charged twice, a drug charged at the wrong quantity, an implant charged on the wrong patient, a charge missing because the order was never resulted. Departments find them late, fix them informally, and nobody knows whether the claim went out, whether it paid, or whether the fix created a false claim or an unreturned overpayment.

A charge correction is a controlled change: who may request it, what evidence supports it, who approves by type and amount, how it posts, what it does to the claim (hold it, correct it, or refund it), and when an identified overpayment must be returned (sixty days for government payers). The segregation between the requester and the approver and the record of the reason are what the compliance program and the auditor look for. The department knows the error; the process should know the consequence.

A correction posted before the claim is a clean claim; one posted after is an overpayment with a deadline.

How it runs

From the requestto the system of record.

A department, a coder or a charge reconciliation report identifies a charge error on an encounter. Callvu opens the correction with the encounter and the claim status.

Department requester: Describes the correction, gives the reason and attaches the evidence through a link.
Revenue integrity approver: Decides the correction in the Decision Desk by type and amount.
Billing and compliance: Post the correction, correct the claim and manage the overpayment return.
Callvu: Prefills, captures, classifies, routes, posts, corrects and clocks.

Prefill and capture
The encounter, the charges with their codes, quantities and dates, the claim status (not billed, billed, paid) and the payer are prefilled from the billing system; the requester captures the correction in structured form (the charge, the action, the new value) with the reason from the policy's list and the evidence (the order, the medication administration record, the procedure log, the supply record) through a link.
Classify
The correction is classified by type (an add for a missed charge, a delete for a duplicate or an unperformed service, a change of code or quantity, a transfer between encounters or patients) and by billing effect (post before the claim; hold and correct a billed claim; refund or recoup where a paid claim was overbilled), with the amount, the payer and the deadline the effect carries; a transfer between patients is flagged as a potential privacy and billing error for compliance.
Decide
The correction goes to the revenue integrity approver in the Decision Desk by type and amount tier with the evidence and the billing effect, and only the allowed outcomes: approve, approve with a different value and the reason, return to the requester for evidence, or deny with the reason; the requester and the approver are never the same person.
Write back and return
The approved correction is posted to the billing system on the encounter, the claim is held until the correction posts or a corrected claim is sent to the payer, an overbilled paid claim starts the overpayment refund or the payer's recoupment with the sixty-day clock for government payers, the correction is logged by department, type and cause for the charge integrity report, and a pattern (a repeated error from one source) opens a root cause review.

Where it ends: The error was corrected with a reason and evidence, approved by someone other than the requester, posted before the claim or corrected on it, and any overpayment was returned within the rule, with the billing system holding the correction and its cause. The Decision Trace shows the classification, the billing effect and the decision; the Audit Trace shows the request, the approval, the posting and the return with time.

Runtime enforcement

What is enforcedwhile the work runs.

The regulations preloaded in Callvu Studio and the bank's own policies, applied as steps that run, not lines in a binder. A step that breaks a rule does not run, so a completed run was compliant.

Regulations

Medicare and Medicaid overpayment return rule (42 USC 1320a-7k(d) and 42 CFR 401.305) and the False Claims Act (31 USC 3729): An identified overpayment from a government payer must be reported and returned within 60 days of identification; retaining it past the deadline is an obligation under the False Claims Act, and a claim knowingly billed with an incorrect charge is a false claim; the correction's classification and clock evidence the identification date and the return.
Medicare claims processing and corrected claim rules (the Claims Processing Manual, the claim frequency codes for replacement and void claims) and payer contract correction rules: A billed claim is corrected by a replacement or void claim with the right frequency code within the payer's timely filing and correction periods; a paid claim overbilled is refunded or adjusted through the payer's process.
The hospital's charge capture and reconciliation policy and the OIG compliance program guidance: The policy sets who may request a correction, the evidence required, the approval tiers, the segregation of duties between requester and approver, the reconciliation of charges to clinical activity, and the audit of corrections; the OIG guidance expects billing compliance controls over charge accuracy and overpayment refunds.

Company policies

Every correction carries a structured reason and evidence; no corrections by email.
The approver is never the requester, and the tier matches the amount and the type.
The billing effect is classified on request; a paid claim overbilled starts the return clock on the identification date.
The billing system is the system of record for the correction, the claim action and the cause.

Controls

Prefill of charges and claim status.
Structured capture with reason and evidence.
Classification by type and billing effect.
Decision Desk approval by tier with segregation of duties.
Posting, claim hold or correction, and overpayment return clock.
Charge integrity logging and root cause review.

Clocks and deadlines

Overpayment return: Within 60 days of identification for government payers.
Claim hold: The claim is held until the correction posts; a corrected claim within the payer's correction period.
Correction approval: The policy's service level, visible to the requester.

Documents and checks

The correction request with reason and evidence
The classification and the billing effect
The approval
The posting, the claim action and the overpayment return
The charge integrity log

In the Decision Trace

The classification and the billing effect.
The decision, its tier and the person.

In the Audit Trace

The request with time (the identification date).
The approval with time.
The posting, the claim action and the return with time.

The handoff

Between the front doorand the back office.

The front door

The department through a link from the encounter or the reconciliation report.

The back office

Revenue integrity approves; billing and compliance act on the posted correction and the return clock.

The Decision Desk

Every correction goes to the revenue integrity approver in the Decision Desk by type and amount tier with the evidence and the billing effect, and only approve, approve with a different value and reason, return for evidence, or deny with reason.

Proof

In scope.Proof at scale, not one process at a time.

The kind of process Callvu runs in production for customers in this industry. Ask for a reference on this exact process. The results below are the industry's published proof; each claim code links to its record on agents.callvu.com.

23 hospitals in the Ministry of Health network run on Callvu.

Across Callvu customers

More than 1,000 processes are live across Callvu customers.

Across Callvu customers

Questions

What buyers ask next,answered plainly.

What does a correction need?

The charge, the action and the new value in structured form, a reason from the policy's list and the evidence (the order, the administration record, the procedure or supply log), captured by the department through a link.

Who approves?

The revenue integrity approver in the Decision Desk by type and amount tier, never the person who requested it.

What if the claim already paid?

The correction's billing effect becomes a refund or recoupment, and for government payers the return clock of 60 days runs from the identification date.

Related processes

Clinical documentation queries Patient refund requests Billing disputes Try it in the sandbox All healthcare processes

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