Incarceration Claim Denials

Providers should have received a refund check dated December 4, 2013, for claims that denied incorrectly due to Incarcerated beneficaiary status. There were other claims that were NOT refunded due to system constraints and Noridian is currently in the process of refunding providers for those funds and reprocessing the claims. This process will take some time due to the large quantity of claims and they have to be manually adjusted. This process will also occur in two parts for each claim and will be occurring until approximately April 2014. First, providers will receive a payment that may contain single to multiple claim refunds. Second, these reprocessed claims will have a letter generated with a listing of the claims that providers will use to match the dollar amounts paid to the claims. Providers may contact the Provider Contact Center if assistance is needed in identifying the name of the patient using the Financial Control Number (FCN) on the listing. Providers will NOT receive a corrected remittance advice (RA) for these claims. A further explanation of why a corrected RA will not be issued, as well as an example of the letter being sent to providers, can be viewed in the PDF provided. Noridian asks providers to please be patient until all claims are reprocessed and to monitor this webpage for updates on the completion date of this process.

MAC JE for California, Nevada and Hawaii

MAC JF for Arizona, Alaska, Idaho, Oregon, Montana, North Dakota, South Dakota, Utah, Washington, Wyoming

SOURCE: Source
INDUSTRY NEWS TAGS: Noridian Healthcare Solutions

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