Claims with Prior Authorizations to be reprocessed

August 16, 2011

On some claims that had a Prior Authorization (PA), the system paid incorrectly. The provider was paid the PA dollar amount, rather than the billed amount. These claims will now be re-processed to pay the billed amount.

For example, a claim was billed for $80.00 but the PA allowed $100.00. The claim previously paid $100.00. Now, the claim will be reprocessed to pay $80.00.

Providers do not need to resubmit these claims.