HMS Update to Part B Claims Pricing Error

To date, Highmark Medicare Servces (HMS), Part A/B Medicare Administrative Contractor (MAC) for jurisdiction 12, continues to perform MASS adjustments to reprocess claims impacted by the -21 percent fee schedule error.

HMS released claims for dates of services on or after April 1, received between April 1 and April 7, paid at the incorrect -21 percent reduced fee schedule due to an internal system error.

Systems corrections have been made, and claims paid at the incorrect -21 percent fee will be reprocessed automatically, HMS says. As of May 6, HMS had completed four cycles of MASS adjustments to reprocess claims in states impacted by the -21 percent fee schedule error.

The contractor says it will continue to release held claims on a first in first out basis, which will process with the correct fee schedule.

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