Claims

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Incorrect rejections for Medicare secondary payer (MSP) claims 

An issue was identified regarding incorrect Medicare secondary payer (MSP) rejections related to billing and submission errors. Claims will be held until the fix is implemented. Once the fix is…

Claims adjusted in error due to an issue that affected some professional claims for the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) model

CMS is aware of an issue that occurred on July 26 that affected some 2021-2024 professional claims for the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH)…

Incorrect rejections for Medicare secondary payer (MSP) claims 

An issue was identified regarding incorrect Medicare secondary payer (MSP) rejections related to billing and submission errors. Claims will be held until the fix is implemented. Once the fix is…

Tips to prevent RTP 12206

Read this article for tips on how to prevent RTP 12206.

Tips to prevent RTP 30960

Read this article for tips on how to prevent RTP 30960.

Reject reason codes

A status R claim is a claim that was rejected for reasons such as Medicare eligibility, billing issues like overlapping with another provider’s claim, Medicare Secondary Payer (MSP) provisions,…

Resolution tips for overlapping claims

This job aid was prepared by the Part A/B and home health and hospice (HHH) MAC collaboration team to help providers that experience claim rejections for overlapping dates of service.

Submitting high dollar claims for single use vials

Read this article to learn more about submitting high dollar claims for single use vials.