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Date ArticleType
11/1/2019 Payment/Reimbursement
Update and Request from AHCA: PDPM Claims Processing

When the PDPM model rolled out last month,  claims submitted in October were either being placed on hold or, if processed, were not recording accurate payments. Many of these issues were resolved by October 24. Since then, AHCA has learned that while some Medicare Administrative Contractors (MACs) have been able to process claims with a single Health Insurance Prospective Payment System (HIPPS) code, none of the MACs are able to process claims with multiple HIPPS codes. CMS has assured AHCA that all MACs should be able to process and accurately pay all claims containing only one HIPPS code in the coming days.  Click this link for more details as well as a request from AHCA to share feedback our your PDPM claims processing experience.

Please contact Elizabeth Eichhorn at eeichhorn@ihca.org with any questions.