An issue has been identified concerning certain clinical laboratory and radiology services that are incorrectly denying with Ref Remark Code N347 indicating that the service was paid by another contractor. The denials are resulting from claims that were posted to the Common Working File (CWF) from the TrailBlazer's 7/10/08 batch cycle for MD/DCMA/DE Part B claims. The CWF reply file from the posting of those claims was not entered into the first batch cycle for Highmark Medicare Services by the Enterprise Data Center. When Highmark Medicare Services resent the same claims to CWF in an attempt to repost for payment, CWF rejected the claims as having already been approved for payment by TrailBlazer. These CWF rejections resulted in incorrect claim denials. Highmark Medicare Services will identify the claims impacted by the incorrect denial and will automatically adjust the claims for proper payment. Additional information concerning the recovery process will be posted to our website when available. We apologize for any inconvenience this has caused.

Early in August our claims processing system inadvertently allowed the distribution of limiting charge monitoring letters. Several years ago, the CMS discontinued the Limiting Charge Exception Report and the sending of compliance monitoring letters. Carriers are only required to assist beneficiaries in obtaining overcharge refunds from providers when brought to their attention. If you received a monitoring letter with instructions to refer to a limiting charge exception report, please disregard it as it was sent in error. You will not be receiving a report.

Highmark Medicare Services has identified an error with the provider type that was assigned by Trailblazer in the Part B shared system for dietitians/nutritionists in the MD/DCMA/DE Part B jurisdictions. This error has caused some claims for Dietitians and Nutritionists to be denied incorrectly. Highmark Medicare Services has corrected the provider type in the shared system and will be identifying and automatically adjusting any impacted claims. We apologize for any inconvenience.

The printing problem related to Pennsylvania Part B checks dated 08/07/2008 and in the check range 049002755 through 049003147 has been resolved and these checks may be deposited at the bank. The issue concerned the number on the hard copy check and the corresponding number that had been provided to the bank. The check numbers at the bank and on the hard copy checks are now in snyc, thus the checks may be deposited. We apologize for any inconvience.