Method II CAH Claims Not Paying Professional Services with Revenue Codes 096x-098x
Part A CAHs in Jurisdiction K and Jurisdiction 6
Description of Issue
Certain CAH claims (TOB 85X) with professional service revenue codes 096x – 098X did not process for payment because the fee amount was not correctly retrieved during processing. The affected claims have receipt/processed dates in October 2024.
National Government Services Action
NGS has reported this issue to FISS. NGS will reprocess claims when brought to our attention. When adjusted by NGS, fees are successfully retrieved for payment.
Provider Action
A mass adjustment of these claims is not planned. Providers may submit claims to NGS for adjustment, ensuring they adhere to claim timely filing requirements. Please continue to check the Production Alerts section of our website and future Email Updates.