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Elizabeth M. Whitehorn, Director

Provider Notice issued 06/21/07

Late Ancillary Claims  

 

To:​

Participating Hospitals – Chief Executive Officers, Chief Financial Officers, and Patient Accounts Managers; Hospice Agencies; Renal Dialysis Facilities; and Ambulatory Surgical Treatment Centers (ASTCs) ​
Date:​ June 21, 2007​
Re:​ Late Ancillary Claims  ​

 

The purpose of this notice is to advise institutional providers of the process they should follow when submitting a late ancillary claim to report late charges (undercharges) or overcharges on previously paid claims.

 

A late ancillary claim only corrects the charges reported on the original claim. It does not affect the payment the provider received on the original claim. If a hospital’s late charges would affect the department’s reimbursement for the service, then the claim must be voided and resubmitted.

Providers have historically identified both late charges and overcharges on the paper UB-92 with a “U” or an “O” following the category of service in Form Locator 56P. The department utilized Type of Bill (Form Locator 4) Frequency Digit 5 for identifying both late charges and overcharges.

The MEDI IEC system only accepts HIPAA-compliant transactions. It does not accept the department’s unique category of service and bill indicators utilized on the UB-92 paper format. Since the definition of Frequency Digit 5 actually specifies its use for denoting late charges only, the MEDI IEC system can only be used to report late charges.

At this time, late ancillary claims reporting overcharges must be submitted on the paper UB-92 claim format. At the time the department implements Frequency Digits 7 (Replacement of Prior Claim) and 8 (Void/Cancel of Prior Claim), they may be used to give providers additional billing options to address both late charges and overcharges.

Any questions regarding this notice may be directed to the provider’s UB billing consultant in the Bureau of Comprehensive Health Services at 1-877-782-5565.

 

Theresa A. Eagleson, Administrator

Division of Medical Programs