Resubmission of Erroneously Denied Every Woman Counts Claims

The Department of Health Care Services (DHCS) identified a claims processing issue affecting some Every Woman Counts (EWC) claims. This issue caused claims to erroneously deny with Remittance Advice Details (RAD) code 9109: This service is not payable for the diagnosis billed. This issue affected claims for dates of service from May 26, 2009, through May 23, 2016.No action is required on your part. Conduent will resubmit the affected claims. These resubmissions will appear on RAD forms beginning February 2, 2017, with Claim Control Number (CCN) roll number 55 (Resubmit).

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INDUSTRY NEWS TAGS: California Medi Cal

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