Author: Provider Reimbursement
North Carolina Medicaid will reprocess Medicare Part B Crossover Professional and Outpatient claims submitted to Medicare from Jan. 2, 2017, to Jan. 5, 2017.
Medicare experienced a claims processing issue with claims submitted Jan. 2, 2017 to Jan. 5, 2017, causing incorrect reimbursement. Medicare performed a mass adjustment to correct the reimbursement of the affected claims. However, when the Medicare adjusted claims crossed over to Medicaid, NCTracks denied them in error. The system error that caused the denial of these Medicare adjusted claims has been resolved.
Applicable claims will be voided in the July 10, 2018, checkwrite. Providers should submit new day claims within 30 days after the July 10, 2018, checkwrite date (New day claims must include the adjusted claim information received from Medicare).
Voided claims will be displayed in a separate section of the paper Remittance Advice (RA) with the unique Explanation of Benefits (EOB) 10244 -VOID CLAIM TO ALLOW PROVIDER TO RESUBMIT THE CLAIM DUE TO ERRONEOUS DENIAL OF MEDICARE CROSSOVER ADJUSTMENT. The 835 electronic transactions will include the voided claims along with other claims submitted for the checkwrite.
Note: There will be no separate 835.