- Issue Name
- Crossover of Anesthesia Bills
- When the MCS system creates a crossover bill, it reports anesthesia times in units. Some secondary payers pay for units rather then minutes and this leads to underpayments.
- See below.
An anesthesia billing representative contacted the PRIT about this underpayment issue. We are discussing possibly solutions with the carrier.
Feb 14: The PRIT met today with the Medicaid Claims processor and the Anesthesia providers. Resolution is forthcoming.
April 18th Progress by the contractor in effecting the change has been disappointing, we are addressing this with the contractor.
May 10: We are working with the CMS Chicago Regional office to get the Change Request through the Indiana Medicaid office.
May 18: EDS EDI Solutions is beta testing a fix made to their systems. They will mass adjust claims from 12/1/2004 and forward, that crossed over from Medicare. It will likely be put into production for June with mass adjustment slated to be completed by early July.