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Date ArticleType
9/7/2017 Payment/Reimbursement
Claims Payment and CORE/MMIS Issues

IHCA continues to field member calls concerning ongoing and new nursing facility claims payment issues. These issues appear to be largely, but not solely, related to CORE/MMIS implementation. Below are recently reported problems. If you have had similar cases, please contact Elizabeth Eichhorn at eeichhorn@ihca.org or (317) 616-9031.

• Residents on traditional Medicaid are appearing as enrolled in managed care with an MCE. However, the MCE has no record of enrollment.
• Mass adjustments for incorrect reporting of nursing home patient liability amounts scheduled for July (as reported in IHCP Bulletin BR201722) have not yet occurred.
• For a resident admitted in late 2016 with an approved 4B and 450B, this member’s case was inexplicably closed.