07/07/2018

Payer Issue Tracking Page

Last Updated 7/10/18

WPS MEDICARE

No WPS Medicare system problems reported at this time.

MEDICAID

Please see the Medicaid section of this newsletter for updates.

BCBSM

No BCBSM system problems reported at this time.

BCN

No BCN system problems reported at this time.

MEDICARE PLUS BLUE (MPB)

No MPB system  problems reported at this time. 

PRIORITY HEALTH (PH)

Problem:  PH now requires that all services be billed on one claim, claims cannot be split.  Split claims are being denied and providers need to resubmit a corrected claim for all services.  This new policy is causing a billing nightmare since for many providers it is impossible to bill everything on the same claim.  MSHO is looking into this issue.

Reported 6/18/18

NOTE: If you have a payer issue that you believe is a system problem and you do not see it listed above, PLEASE report it to MSHO! 

To report, email the description of your issue, including the ICN Number, date of service, provider number and patient contract number to billing@msho.org.  Do not include the patient’s name.

REMINDER – MSHO’s role is to resolve payer issues that will/can impact all members; we do not address individual claim issues. Unique, patient specific issues should not be reported.