Healthcare
13 columns
100 rows
8 formats

Claim Resubmission and Corrected Claims

This dataset captures detailed records of healthcare claim corrections and resubmissions, including original claim references, correction reasons, specific data element changes, submission dates, and payment recovery tracking. It enables robust audit trails, financial reconciliation, and compliance monitoring for healthcare providers and payers.

last updated 2 Nov 2025
by GoMask

The brief that made it

Audit and compliance tracking of claim corrections and resubmissions

Sample rows

preview · 8 of 100 rows · all 13 columns

resubmission_idstring	claim_statusstring	payment_recovery_amountfloat	payment_recovery_flagboolean	payer_idstring	original_claim_idstring	correction_reasonstring	corrected_field_namestring	original_valuestring	corrected_valuestring	resubmission_datedate	provider_idstring	tracking_numberstring
RCLM-2398A7B1	pending	blank	false	PAY-EXPRESS	CLM-9827D4CA	Typo in procedure code	procedure_code	99213	99214	2024-03-05	PRV-1042	TRK-3802-1A
RCLM-4837F2B9	approved	20	true	PAY-UNITED	CLM-5120B8DD	Incorrect billed amount	billed_amount	220.00	200.00	2024-02-28	PRV-2087	TRK-3802-2A
RCLM-2398A7B2	denied	blank	false	PAY-EXPRESS	CLM-9827D4CB	Diagnosis code update	diagnosis_code	J20.9	J21.9	2024-03-10	PRV-1043	TRK-3802-3A
RCLM-4837F2BA	recovered	blank	false	PAY-UNITED	CLM-5120B8DE	Patient birthdate correction	patient_birthdate	1978-06-18	1978-06-17	2024-03-02	PRV-2088	TRK-3802-4A
RCLM-2398A7B3	approved	blank	false	PAY-BLUECROSS	CLM-9827D4CC	Service date update	service_date	2024-01-15	2024-01-16	2024-03-14	PRV-1044	TRK-3802-5A
RCLM-4837F2BB	pending	15.5	true	PAY-AETNA	CLM-5120B8DF	Incorrect modifier	modifier	25	59	2024-02-19	PRV-2089	TRK-3802-6A
RCLM-2398A7B4	denied	blank	false	PAY-BLUECROSS	CLM-9827D4CD	Typographical error in provider ID	provider_id	PRV-1054	PRV-1045	2024-03-12	PRV-1045	TRK-3802-7A
RCLM-4837F2BC	pending	blank	false	PAY-BLUECROSS	CLM-5120B8E0	Corrected payer ID	payer_id	PAY-SHIELD	PAY-BLUECROSS	2024-02-25	PRV-2090	TRK-3802-8A
RCLM-2398A7B5	approved	blank	false	PAY-EXPRESS	CLM-9827D4CE	Incorrect place of service	place_of_service	11	22	2024-03-08	PRV-1046	TRK-3802-9A
RCLM-4837F2BD	approved	blank	false	PAY-AETNA	CLM-5120B8E1	Incorrect CPT code used	cpt_code	87070	87071	2024-02-22	PRV-2091	TRK-3802-10A
RCLM-2398A7B6	recovered	blank	false	PAY-BLUECROSS	CLM-9827D4CF	Incorrect patient gender	patient_gender	M	F	2024-03-11	PRV-1047	TRK-3802-11A
RCLM-4837F2BE	pending	blank	false	PAY-UNITED	CLM-5120B8E2	Incorrect NPI for provider	provider_npi	1234567890	0987654321	2024-02-27	PRV-2092	TRK-3802-12A
RCLM-2398A7B7	pending	blank	false	PAY-EXPRESS	CLM-9827D4D0	Patient address update	patient_address	234 Main St	234 Main Street	2024-03-13	PRV-1048	TRK-3802-13A
RCLM-4837F2BF	approved	blank	false	PAY-AETNA	CLM-5120B8E3	Incorrect primary diagnosis code	primary_diagnosis_code	E11.9	E66.9	2024-02-24	PRV-2093	TRK-3802-14A
RCLM-2398A7B8	approved	blank	false	PAY-BLUECROSS	CLM-9827D4D1	Incorrect referring provider	referring_provider	Dr. Smith	Dr. Smythe	2024-03-09	PRV-1049	TRK-3802-15A
RCLM-4837F2C0	denied	blank	false	PAY-EXPRESS	CLM-5120B8E4	Incorrect facility ID	facility_id	FAC-2301	FAC-2302	2024-02-26	PRV-2094	TRK-3802-16A
RCLM-2398A7B9	recovered	45.75	true	PAY-UNITED	CLM-9827D4D2	Incorrect billed units	billed_units	1	2	2024-03-07	PRV-1050	TRK-3802-17A
RCLM-4837F2C1	pending	blank	false	PAY-BLUECROSS	CLM-5120B8E5	Incorrect patient ID	patient_id	PAT-1024	PAT-1025	2024-02-23	PRV-2095	TRK-3802-18A
RCLM-2398A7C0	approved	20	true	PAY-EXPRESS	CLM-9827D4D3	Billed amount too high	billed_amount	520.00	500.00	2024-03-15	PRV-1051	TRK-3802-19A
RCLM-4837F2C2	denied	blank	false	PAY-AETNA	CLM-5120B8E6	Incorrect authorization number	authorization_number	AUTH-2000	AUTH-2001	2024-02-21	PRV-2096	TRK-3802-20A

What the 100 rows show

from the 100-row sample

Recovered (claim status) stands out: 11 of its 14 rows have payment_recovery_flag = true, against 5 of 86 for the rest.

16%payment_recovery_flag = true
32.9median payment_recovery_amount

Payment recovery flag rate by claim_statuspayment_recovery_flag = true

payment_recovery_amount16 rows, in bands of 20

Median 32.9, from 10.0 to 200.0.

payer_id100 rows · 8 values

PAY-BLUECROSS14
PAY-AETNA13
BCBS-TX13
Aetna-TX13
PAY-UNITED12
Humana-TX12
United-TX12
PAY-EXPRESS11

13 columns by typefrom the column list below

string 10
float 1
date 1
boolean 1

Columns

13 columns in four groups

blueprint · 13 columns
column	type	description	example
Text 10 columns
`resubmission_id`	string	Unique identifier for each claim resubmission or correction eventunique	RCLM-2398A7B1
`original_claim_id`	string	Reference ID of the original claim being corrected or resubmitted	CLM-9827D4CA
`correction_reason`	string	Explanation or code indicating the reason for claim correction or resubmissionup to 255	Typo in procedure code
`corrected_field_name`	string	Name of the claim field that was corrected (e.g., procedure_code, billed_amount)up to 100	procedure_code
`original_value`	string	Original value of the corrected field before resubmissionup to 255	99213
`corrected_value`	string	New value of the corrected field after resubmissionup to 255	99214
`payer_id`	string	Identifier for the insurance payer or responsible organizationup to 50 · 8 payers	PAY-EXPRESS
`provider_id`	string	Identifier for the healthcare provider submitting the corrected claimup to 50	PRV-1042
`claim_status`	string	Status of the corrected claim (e.g., pending, approved, denied, recovered)pending · approved · denied · recovered	pending
`tracking_number`	string	Tracking number for monitoring claim correction and payment recovery processunique · up to 36 · optional	TRK-3802-1A
Numbers 1 column
`payment_recovery_amount`	float	Amount to be recovered due to overpayment or correction (if applicable)0 or more · optional	20
Dates and times 1 column
`resubmission_date`	date	Date when the claim correction or resubmission was submitted	2024-03-05
True or false 1 column
`payment_recovery_flag`	boolean	Indicates if payment recovery is required due to the correction (true/false)	false

Use it for

A healthcare dashboard
The payment_recovery_flag rate, payment_recovery_amount by claim_status and a breakdown of payer_id. Excel, Power BI or Tableau.
Why do 16 of 100 rows have payment_recovery_flag = true?
A root-cause class exercise
Hand out the rows and one question. The answer is in the data, not in the brief.
Resubmissions100
RCLM-2398A7B1pending
RCLM-4837F2B920approved
RCLM-4837F2BB15.5pending
A software demo
Believable resubmissions with original_claim_id, correction_reason and corrected_field_name to fill a screen in front of a buyer.

This dataset100 rows13 columns

Yours10,000 rows13 columns

blueprint · claim-resubmission-and-corrected-claims

Behind this dataset

Same schema. As many rows as you need.

These 100 rows came out of a blueprint — 13 columns with generation rules behind each one. Open it in Data Factory to retune a column, add your own, wire in foreign keys, and run it at the size you actually need.

Rules it was built with

Corrected claim indicator in loop 2300
Original claim reference number (ICN or DCN)
Correction reason: coding error, wrong payer, missing info, etc.
Corrected data elements documented
Resubmission date within timely filing
Void and replace vs adjustment claim
Payment recoupment if overpaid on original
Additional payment if underpaid

Rows1,000 rows10,000 rows100,000 rows1,000,000 rows

Open the blueprint in Data Factory

1 credit per row. New accounts start with 25 free credits.

Exports: CSV, JSON, JSONL, Parquet, SQL, Excel, TSV, XML
Licence: yours to use, including commercially
API slug: claim-resubmission-and-corrected-claims

What should your data show?

No signup. No card.

Sample rows

What the 100 rows show

Columns

Use it for

A healthcare dashboard

A root-cause class exercise

A software demo

Make it yours.

Same schema. As many rows as you need.

More in Healthcare

What should your data show?