HFSMedical ProvidersClaims Processing System IssuesClaims for (SASS) were processed incorrectly.

Claims for (SASS) were processed incorrectly.

Claims for Screening, Assessment and Support Services (SASS) were processed incorrectly.

Updated: 09/29/15   

HFS System Issue:  

Claims for Screening, Assessment and Support Services (SASS) were processed incorrectly.

Problem:

SASS payable and rejected claims were processed incorrectly, resulting in failure to generate paper remittance advice and payment to providers for claims that processed as payable but were coded as ‘non-payable’ in error. 

Providers Impacted:

Community Mental Health Providers

Procedure Codes Impacted:

All SASS procedure codes

Problem Begin Date:

The issue began with claims received on and after 09/08/2014

Problem Fix Date:

05/10/2015

Resolution for Impacted Claims:

The issue was identified on 03/05/15.  As a result, all SASS claims received after 03/05/15 were held in pending status until the problem was fixed.  When the issue was resolved, claims held in pending status were released and processed correctly.

All affected claims that had processed incorrectly were identified.  Payable claims that had processed incorrectly with non-payable status were systematically voided by the department on 9/25/2015.  Individual reports identifying both the voided and rejected claims affected by this system issue have been sent to providers.  All affected claims detailed on those individual reports have been systematically authorized for timely filing override and must be rebilled by providers

**PLEASE NOTE:  Providers must contact a billing consultant at 877-782-5565 (press ‘0’ and ask to speak with a community mental health billing consultant) to modify the time override if any of the following parameters on a rejected claim needs to be modified upon resubmission:  provider number, recipient ID number, date of service, procedure code.

Providers should have affected claims resubmitted by 10/15/2015. 

 


Claims Processing System Issues

 

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