Void and Resubmission of Erroneously Paid Medical Claims

The Department of Health Care Services (DHCS) has identified a claims processing issue with some medical claims billed with a begin date of service greater than the end date of service. The issue affected claims for dates of service from January 1, 2013, through May 23, 2016. No action is required on your part. Xerox State Healthcare, LLC (Xerox) will void and resubmit erroneously paid claims. Voids will appear on Remittance Advice Details (RAD) forms beginning January 26, 2017, with RAD code 0819: Void and resubmit of claims processed in error. Corresponding resubmissions will appear on RAD forms beginning February 2, 2017, with Claim Control Number (CCN) roll number 55 (Resubmit). The roll number is the fifth and sixth digits of the CCN.