Medicare Coverage Not Recognized

Some of the claims for AHCCCS members who are Dual Eligible are being denied due to the system not reading the Medicare eligibility begin and end date segments. These two issues in total comprise a small number of claims. The AHCCCS Information Services Division (ISD) has analyzed and built system logic that will address and correct the issue.  The Division of Fee-For-Service Management (DFSM) is currently in the process of testing the new system logic and anticipates a promotion date of the new logic on 07/20/17. Once the new logic has been tested and promoted, DFSM will identify claims that have been inappropriately denied and then will schedule a claims recycle to reprocess the identified claims. 

SOURCE: Listserve 6/24/2017
INDUSTRY NEWS TAGS: Medicaid Arizona

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