Medical and dental claims processing inappropriately

Medical and dental claims processing inappropriately

HP has identified an issue with the claims processing system. This issue affects claims processed December 24, 25, and 26, 2014. Claims may have been inappropriately paid or denied. Providers will see the following explanation of benefits (EOB) codes on their Remittance Advices (RAs):

  • 4184 - Claim successfully processed through NCCI editing during recycle process. Therefore, appropriate EOB's will be posted applicable to claim
  • 4185 - The claim did not process through National Correct Coding Initiative (NCCI) editing. The claim will be reprocessed or adjusted at a later date. Please monitor future Remittance Advice statements for processing activity related to this claim

HP is reprocessing and mass adjusting all claims associated with this issue as of today. Providers will begin seeing reprocessed and adjusted claims on Remittance Advices (RAs) as of Tuesday, January 6, 2015.