November 23, 2022 Update: Please read new communications here.
Claims submitted for dates of service between June 1, 2021 and September 7, 2022 are not subject to the updated E&M commercial reimbursement policy. All new recoupment requests were halted prior to our communication on October 17, 2022. We advised providers to ignore any requests they received. However, recoupment requests that were sent to providers prior to October 17, 2022 have continued to be automatically voucher deducted at 45 days. Work is underway to make system updates to reverse the recoupment process and ensure affected providers are refunded recouped money with interest where applicable.
We apologize for the confusion, and we’re working as quickly as possible to make things right. We appreciate your ongoing patience as we continue our work to resolve this. If you have questions or need assistance, please contact our Provider Blue Line at 1-800-214-4844.
This communication applies to the following lines of business: Administrative Services Only (ASO), fully insured membership, IPP Host, and the State Health Plan (SHP).