Claims Denials, Aug. 24 Provider Council Meeting

On Tuesday, August 8, Partners sent a Provider Alert asking all providers to make sure they had entered the taxonomy in their claim properly. You must use the drop-down menu to select the taxonomy. You cannot simply enter the number—it will not self-populate. Additionally, providers entering claims need to make sure that they have entered the taxonomy in field 33b.

Since the alert was sent, Partners’ Claims Department has identified that approximately $550,000 in claims still lack the taxonomy. These claims will DENY in the next checkwrite (August 22, 2017) if the claim is not corrected by Tuesday, August 15, 2017.

How will I know if my claims lack the taxonomy data?
Providers, especially those entering portal claims, are urged to review their Claims Download Que to see which claims are denied.

I have denied claims. What do I do now?
You will need to re-enter the claim and make sure to properly enter the taxonomy in two places within AlphaMCS—in the claim line and in 33b. Partners is unable to re-adjudicate these claims.

Remember to select the taxonomy from the dropdown menu to prevent denials. Below are images of the two areas where you must enter the taxonomy via the drop down menu.

What if I need further assistance?
Please address any claims-related questions to the Partners’ Claims Department at claims_department@partnersbhm.org or call 704-842-6486.