Claims processing problem fixed – mass adjustment update

The Indiana Health Coverage Programs (IHCP) has fixed the system issue identified in the October 24, 2014, News and Announcements article. The issue caused some claims to pay or deny in error regarding National Correct Coding Initiative edits (NCCI). The issue affected claims submitted on or after October 16, 2014. Providers may have received inappropriate denials or incorrect payments on their Remittance Advice (RA) statements. To prevent any additional inappropriate claim denials or incorrect payments, HP held claims submitted on or after Tuesday, October 28, 2014. These claims were released for processing, and providers can expect to see these claims appear on the Remittance Advice (RA) dated November 4, 2014. Claims previously denied with the preceding EOBs have also been reprocessed and will appear on the November 4, 2014, RA. On Monday, November 3, 2014, HP began mass adjusting claims that were previously processed and paid incorrectly. Providers will begin seeing the mass adjustments appear on their November 11, 2014, RAs. The mass adjustments for all affected claims should be completed by November 24, 2014.