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Known Issues and Resolution Timeframes

Updated 01/31/2022

If you have a claim that should be included in one of the claim projects below (which you believe denied incorrectly) and it has not yet been adjusted, please let us know the claim number so that we can research it and confirm. You may email us or contact your Provider Relations Rep.

Open Issues

OPEN ISSUE DESCRIPTION

IMPACTED PROVIDER TYPE

ISSUE RESOLUTION STATUS

CLAIM PROJECT STATUS

TARGET COMPLETION DATE

CLAIM PROJECT #

n/a

n/a

n/a

n/a

n/a

n/a



ISSUE KEY

ISSUE RESOLUTION STATUS

Research

Issue under investigation to determine root cause

Solution Identified

Issue has been identified, but no system updates (to date) have been made

Full Resolution Deployed

Issue has been corrected in the system and all of the system updates have been made

 

CLAIM KEY

CLAIM PROJECT STATUS

In Process of project creation

Project under investigation to determine affected claims and providers

Project in Process

Claim project has been initiated, provide payment will begin within next 7 days

Project Complete

Claims included in the claim project have reprocessed. Note, this is not a guarantee of payment, during reprocessing claims may hit additional claim edits

For questions about global issues or the associated claims projects, please contact Provider Services or your Provider Relations representative.

Special Projects in Process

SPECIAL PROJECT NAME

PROJECT DESCRIPTION

ESTIMATED CLAIMS PROCESSING DATE

ACTUAL CLAIMS COMPLETION

PROJECT NUMBER

n/a

n/a

n/a

n/a

n/a



Recovery Projects

Recovery notice letters to be mailed to providers within 30 days of the project being submitted.

RECOVERY PROJECT NAME

PROJECT DESCRIPTION

RECOVERY ESTIMATED COMPLETION DATE

NOTIFICATION LETTERS SENT

PROJECT NUMBER

n/a

n/a

n/a

n/a

n/a



Completed Projects

Below is a listing of completed claim projects. If you have a claim that should be included in one of the completed claim projects below (which you believe denied incorrectly) and it has not yet been adjusted, please let us know the claim number so that we can research it and confirm. You may email us or contact your Provider Relations Rep.

COMPLETED ISSUE DESCRIPTION

IMPACTED PROVIDER SPECIALTY

ESTIMATED CLAIMS REPROCESSING DATE

ACTUAL CLAIMS COMPLETION DATE

PROJECT NUMBER

n/a

n/a

n/a

n/a

n/a

 

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