Meridian MCS Claim System Retirement and Reminders on Timely Claim Filing Limits, Complaints and Disputes
Date: 9/14/2023
As previously communicated, Meridian has migrated to a new claim processing system on April 1, 2022. All claims for dates of service on or before March 30, 2022, have continued to process in our legacy system known as MCS. Timely filing limits for MCS applicable claims expired April 1, 2023. Consequently, Meridian will retire the MCS claim system effective September 30, 2023. Providers should be mindful of the guidelines outlined below if seeking resolution of any outstanding MCS applicable claims.
What does this mean?
Claim projects and disputes for dates of service on or prior to March 31st, 2022, that are currently in motion will continue to be worked until resolution is completed. The dispute portal for DOS on/prior to March 31st, 2022, will be closed and new claim disputes will not be accepted after 8/1/2023. This includes settlement requests that have not already been reported.
Important Reminders
- New claims must be submitted within 365 days from the date of service.
- Disputes can be submitted within the 365 days timely filing limit or 120 days from the last denial as long as the original claim was received within 365 days.
- All new claim submissions would be considered outside of timely filing for dates of service on/prior to March 31st, 2022.
We are committed to resolving claim issues and ensuring payment in accordance with the Michigan Department of Health and Human Services’ guidelines, national correct coding, and contract arrangements. Also, we offer our providers multiple options to have claims reviewed and reconsidered prior to a formal dispute.
Questions
- Providers can contact their Provider Network Representative for additional information or questions regarding claim submissions and disputes using the online Provider Relations Intake Form on the Meridian website.
- Providers who need assistance connecting with their Provider Network Representative can find a representative map at: mimeridian.com OR contact Meridian Provider Customer Service at: 888-773-2647 (TTY 711)
Formal Claim Dispute
When providers delay in notifying Meridian of an issue, a review of the aged claims may not be able to be accommodated. In those instances, a formal claim dispute may be filed. Please see the Meridian Provider Manual for additional details.