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Elizabeth M. Whitehorn, Director

Rebilled Non-Emergency Transportation Claims Denying G55, 180 Day Timely Filing

HFS System Issue:

Non-emergency transportation claims that were previously suspended with code D04, rejected G55, 180- Day Timely Filing Limit, when they were rebilled.  HFS posted a webpage on April 27, 2015 stating the claims could be rebilled, and they would bypass the timely filing edit for error code, G55, 180-day timely filing.  

See System Issue Page, Non-Emergency Transportation Claims Suspended, D04, Pricing Problem.   

Problem:

The previously suspended non-emergency transportation claims that were rebilled denied, G55, 180-day timely filing.   An electronic override to bypass the timely filing error that was to allow the claims to pay was entered incorrectly.  As a result, the rebilled claims denied.

Providers Impacted:

Non-emergency transportation providers

Procedure Codes Impacted:

A0090, A0100, A0120, A0130, A0422, A0425, A0428, T2001

Problem Begin Date:

Claims rebilled on and after April 27, 2015.  The claims affected were previously submitted between December 27, 2012 and July 11, 2014.

Problem Fix Date:

May 20, 2015

Resolution for Impacted Claims:

Claims can be rebilled electronically, and they will bypass the timely filing edit.  Providers have 180 days from the fix date to rebill affected claims.