CHAP News Alert - CMS DMEPOS Update
Jul 29, 2011
B7 Denials Resolved
(Reposted from AAHomecare)
July 26, 2011
NHIC, the Jurisdiction A DME MAC, has provided an update on reprocessing of claims that received B7 denials in error based on an edit that was turned on July 5. This error code indicates that the supplier was not certified/eligible to be paid for this procedure/service on this date of service.
On July 19, CMS instructed the DME MACs to turn off the edit. Providers should no longer see B7 denials after that date. Claims that were denied prior to that date will be automatically reprocessed. AAHomecare has been in contact with CMS and the NSC on the issue and has requested that reprocessing occur within the prompt payment rules. According to the NHIC update, the DME MACs will begin an adjustment process next week to automatically correct the denials.
The NSC, DME MACs, and CMS are working on a permanent solution to the issue prior to reactivating the edits. AAHomecare will continue to monitor the issue as the process moves forward.
The complete update from NHIC:
On 07/19/11
, all DME MACs were instructed by CMS to deactivate the edit causing the B7 denials. As of 7/19, claims should no longer be denying due to this issue. A date has not yet been received for the reactivation of this edit, which will occur once the permanent solution to this issue has been determined.
NHIC will be issuing an express adjustment process early next week to automatically correct those claims denied in error. It will not be necessary for our supplier community to re-submit or contact our office concerning the denials.
We apologize for any disruption this may have caused and appreciate your patience as we work to resolve this issue.