Billing Beat

QMB/Spenddown Claims Denied in Error, CR 56707

May 26, 2017

An issue was identified where some crossover claims denied in error. The error occurred when the member had Medicare for primary insurance and Qualified Medicare Beneficiary (QMB) coverage with a spenddown as secondary insurance. The claim should have processed with QMB coverage, but instead denied in error. The issue has been corrected and claims that denied in error will be reprocessed. No provider action is needed.

Source: https://content.govdelivery.com/accounts/MEHHS/bulletins/19aefe2

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