Inpatient Transfer Duplicate Denial

Nature of Issue: Inaccurate Duplicate Claim Denial when there is a same day Hospital to Hospital Transfer

Date Identified: 5/10/2024

Dates of Service Impacted: 1/1/2023 to Current

Product Line Impacted: MMP and Medicaid

Summary of Issue: Inpatient transfer claims are
experiencing payment issues due to system incorrectly identifying them as duplicate admissions. Issue has been identified, configuration update is in production as of 5.15.2024, project has been submitted as of 5.24.

New Claim Submission Issue Resolution Date: 5/15/2024

Prior Claim Correction Issue Resolution Date: 8/1/2024

Any action required by the provider if applicable: N/A - System update complete, adjustments in progress