Claim denials for insufficient documentation is a common occurrence. For more information on submitting documentation with your appeal request visit the Appeals web page.
WPS Receives Global Award For Excellence In Case Management!
The Workflow Management Coalition presented WPS Health Solutions with a 2016 Global Award for Excellence in Case Management for its use of OnBase in the Government Health Administrators division. WPS was selected for its use of OnBase by Hyland to connect and automate information to review and enroll physicians and medical facilities that offer Medicare services. WPS used the OnBase enterprise information platform to streamline its credentialing process for provider enrollment, reduce printing costs, simplify its reporting processes related to provider enrollment applications, and achieve provider enrollment timeliness and quality standards.
Provider Submitted Adjustment Claim(s)
It has come to our attention that the "Voluntary Refund" adjustment reason codes (VB, VC, VD, VE, VF, VG, VH, VI, VL, VM, VN, VP, VR, VS, VV or VW) are being submitted on provider initiated adjustment claim(s). These codes are intended for Medicare Administrative Contractor (MAC) use only. Therefore, effective August 1, 2016, provider submitted adjustment claim(s) that contain a "Voluntary Refund" adjustment reason code will be returned to you for correction.
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System related claims processing/payment alerts reported to CMS and the Fiscal Intermediary Standard System (FISS) maintainer for research and correction. Please refer to these important messages before contacting our Customer Service Area.Learn More >>
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