MHCP Provider News: Claims Processing Issues
February 28, 2013- Claims that denied or paid incorrectly because of missing or invalid ordering/referring provider information for dates of service 5/21/12 through 2/11/2013 will be reviewed and reprocessed over the next few months.
- Secondary claims submitted with Claim Filing Indicator 16 (Health Maintenance Organization (HMO) Medicare Risk) and Claim Adjustment Reason Code PR3 (Patient Responsibility/Co-payment amount) between June 1, 2012, and October 25, 2012, did not process correctly. MHCP expects to reprocess these claims in the near future.