Billing Beat

Update to MIHMS: Previously Denied Claims will Now Process When Resubmitted

April 29, 2016

Medicaid Maine has discovered an issue when some services are denying as a duplicate when the same date of services was denied on a previously paid claim. This is happening on claims that are processed but not all lines are paid. When the claim is in a paid status, but one or more lines on the claim is denied, a resubmission of the denied line will cause another denial as duplicate.  The resubmission of the second claim is currently being denied as a duplicate service. This correction will allow you to resubmit the denied lines without reversing the original claim, and receive payment as long as the services are covered by MaineCare. A notification will be sent out when this issue is corrected.

Source: https://content.govdelivery.com/accounts/MEHHS/bulletins/1410dc9

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