Top Duplicate Claims FAQs

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WPS Medicare publishes Frequently Asked Questions (FAQs) based upon the top duplicate denials we identify. The following FAQs are based upon the top reasons WPS Medicare denied claims as duplicates for the previous quarter.

  1. What are the top duplicate denials for providers during the previous quarter?

    The following table lists the duplicate denials our Medicare providers received during the previous quarter.

    Top Duplicate Denials

    Second Quarter Fiscal Year (FY) 2012 (January, February, and March 2012)

    Description Occurrences Percentage of Total Claims
    Duplicate Paid On Another Claim 507,729 4.69%
    Duplicate Charge...Now Being Processed 312,903 2.89%
    Duplicate Of Another Service On Claim 11,390 .11%
    Duplicate of Charge We Have Processed 1,322.01%
  2. What does "DUPLICATE PAID ON ANOTHER CLAIM" mean to a provider or provider staff?

    It means that WPS Medicare previously issued a payment for the service. The provider needs to research previous claims payments to determine when Medicare adjudicated the claim.

  3. What does "DUPLICATE OF ANOTHER SERVICE ON CLAIM" mean to a provider or provider staff?

    A claim for the same service, for the same provider, and with the same date of service is currently in process. We are unable to change the claim until it has completed processing. Please hold all claims until the initial claim finalizes.

  4. What does "DUPLICATE CHARGE … NOW BEING PROCESSED" mean to a provider or provider staff?

    Medicare paid a claim for the same service, the same provider, and with the same date of service submitted on the same claim. If you were seeking payment for multiple services, check to see if you can quantity bill the service or if a modifier is appropriate.

  5. What does "DUPLICATE OF CHARGE WE HAVE PROCESSED" mean to a provider or provider staff?

    WPS Medicare did not issue a payment for the service but applied it to a patient's deductible. The provider needs to research previous claim payments to determine when Medicare adjudicated the claim and must bill the patient or the supplemental insurance for the patient's deductible.

Page Last Updated: Thursday, 19-Apr-2012 14:58:07 CDT