Retroactive Terminations Due to Incarceration (I), Nursing Facility Placement (N), Or Death (D)

March 17, 2025

Meridian is currently working on multiple projects related to retroactive terminations due to incarceration (I), nursing facility placement (N), or death (D). These projects are based on retro terminations received on the 834 Files from the Michigan Department of Health and Human Services (MDHHS).

Per Meridian’s contract, claims may be recouped before capitation is recovered for these specific disenrollment reasons. As a result, any paid claims with a date of service after the member’s retro termination date will be adjusted and denied with Explanation Code 28: Member not eligible on date of service.

We appreciate your attention to this matter and your cooperation as we work through these necessary adjustments.