J15 Part A Claims Processing Issues Log
Listed below are current system-related claims processing issues that have been reported to the Centers for Medicare & Medicaid Services (CMS) and/or the Fiscal Intermediary Standard System (FISS) Maintainer. This information is made available and updated on a weekly basis so you may review prior to contacting the Part A Provider Contact Center. A list of resolved issues is also available at the end of this list. If you still have questions, please call 866.590.6703.
|Reason Code/Status Location||Situation||Status|
|31824||Hospitals were advised to hold certain A/B Rebilling outpatient claims.||
Once the correction goes in, providers may submit the held claims or F9 claims that are in RTP status.
|U538H||Incarcerated beneficiary claim denials||
To reconcile the RA, access the claims listed in the spreadsheet in DDE to obtain the individual claim amount. The total of the individual claims may not equal the total check amount on the spreadsheet since other offsets may have occurred. After research, if you cannot determine the claim information for the offsets or you have specific questions, you may contact the Part A PCC at the number listed above.