HGSA has informed providers that it and other Medicare carriers have experienced an increase in the number of rejected claims due to mismatch between the claims information and the Common Working File. The increase began in October and is linked to edits required by the Centers for Medicare and Medicaid Services. HGSA suggests that providers ensure that the beneficiary name used on claims is entered exactly as that on the Medicare card. Claims that are rejected are considered incomplete claims rejections, which require providers to research files, correct the beneficiary information in the files, and resubmit the claims. For further information contact Betty Simmonds at PCPA.
