ARTICLE
Over the last week, numerous INARF members have reported denials of August claims for Day Habilitation group services. On Tuesday, IHCP released BR202037, which indicated that providers may resubmit FSW claims for day habilitation services that denied inappropriately. INARF members attempted to resubmit these claims, and many continued to receive denials. This morning, INARF staff spoke to BDDS leadership regarding these widespread billing denials, confirming that the change announced in the IHCP bulletin had not fully addressed the billing issues and clarifying that the issue appears to occur when the group ratio billed was not authorized on the NOA. BDDS confirmed that Day Habilitation group services are intended to have flexibility in the ratios and that the claims should not be denying for this reason. BDDS is working to address the issue. INARF will share additional information when it is available.
Over the last week, numerous INARF members have reported denials of August claims for Day Habilitation group services.
On Tuesday, IHCP released BR202037, which indicated that providers may resubmit FSW claims for day habilitation services that denied inappropriately. INARF members attempted to resubmit these claims, and many continued to receive denials.
This morning, INARF staff spoke to BDDS leadership regarding these widespread billing denials, confirming that the change announced in the IHCP bulletin had not fully addressed the billing issues and clarifying that the issue appears to occur when the group ratio billed was not authorized on the NOA.
BDDS confirmed that Day Habilitation group services are intended to have flexibility in the ratios and that the claims should not be denying for this reason. BDDS is working to address the issue.
INARF will share additional information when it is available.