Provider Notification Letters Alert
Effective July 2, 2007, the letters sent by Medicare contractors to notify a provider that a claim aborted and did not forward to the supplemental insurer has changed. The letters now include the Claredi HIPAA and/or trading partner rejection code and the description. The rejection code information should enable the provider's billing agent/vendor to determine why claims previously selected by Medicare for crossover are no longer able to be forwarded to the supplemental insurer.
The rejection code description is limited to 100 bytes. This limitation does not allow complete descriptions to print in the letters. Providers need to contact their billing agent/vendor to obtain a better understanding of these rejection codes and accompanying descriptions. We encourage providers to notify their billing agent/vendor when they receive the provider notification letters or reports stating why their patients' claims were not crossed over.
Please note that if a claim does not crossover to the supplemental insurer, Medicare contractors cannot regenerate a claim to the supplemental insurer. The provider must submit the claim to the supplemental insurer.
Page Last Updated: Thursday, 18-Mar-2010 05:55:24 CDT
