Highmark "Denied Claims" system alert

On June 12, 2008, Highmark Medicare Services Inc. erroneously denied claims and adjustments with message B7 - This provider was not certified/eligible to be paid for this procedure/service on this date of service. This message will be shown on the standard provider remittance (SPR) of the claim and/or adjustment. The adjustment activity on previously paid services automatically generated a demand (refund) request through the Healthcare integrated General Ledger Accounting System (HIGLAS).

After reviewing several options to correct this situation, Highmark Medicare Services Inc. has decided to mail the demand (refund) letters. The impacted providers need to repay the amount indicated in the demand (refund) letter to Medicare. If you wish to request immediate offset, call 1-888-291-2623.

All impacted claims and adjustments will be re-adjusted to pay as appropriate under a separate payment.