Billing Beat

Secondary Claims not processing correctly

October 25, 2012

Effective June 1, 2012, secondary claims which include Claim Filing Indicator 16 (Health Maintenance Organization (HMO) Medicare Risk) and Claim Adjustment Reason Code PR3 (Patient Responsibility/Co-payment amount) are not processing correctly. MHCP will post a Provider News Message when this issue is corrected and will reprocess these claims as appropriate. Continue to submit claims as usual.

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