AUC EOB/Remit TAG Meeting Minutes February 16, 2016 1:00 pm
Agenda Item
Discussion
Action
1. Facilitators: Pete Anderson, Lisa Wichterman
Minute Taker: Lisa Wichterman
2. AUC Antitrust Statement http://www.health.state.mn.us/auc/antitrust.pdf
3. Welcome and Introductions:
Please email attendance to Lisa Wichterman
[email protected]
4. Approve previous minutes.
5. Future MN 835 CG technical updates.
6. MN ERA best practices, continuing outreach,
technical assistance, and education to ensure
understanding and proper use of the 835 and
CARCs and RARCs.
No formal minutes were taken for the
last meeting in November 2015.
Proposing having a link to the DLI
website in the Companion Guide.
Reviewed overpayment scenarios and
possible results.
 Provider discovers error
 Claim billed correctly, but paid
incorrectly
 Payer discovers error and
initiates correction.
Refund by paper check
Return original uncashed check
Provider waits for payer to adjudicate
the claim.
TAG will carry this forward to the next
meeting to draft best practices.
Agenda Item
Discussion
Action
TAG discussed scenarios regarding COB
overpayments and credits.
The ASC X12 5010 835 guide does
provide examples of COB situations.
TAG created COB examples were the
secondary payer overpays.
7. Replacement claims
8. Industry updates
9. Other Business
BCBS is looking for direction with
replacement claims so providers can
auto posts the 835s. Issue is when
providers resubmits a claim removing a
line item. Providers indicate the
replacement claim goes out with a new
account number.
IAIABC ProPay committee meets
2/17/16.
NCVHS hearings are today on
attachments
DLI has proposed legislation to move
effective date of the 275 to 1/1/17.
None
BCBS received guidance from the
providers on what their systems can
receive without rejections for
replacement claims.
Next Meeting:
Monday March 21, 2016
1:00 PM – 2:30 PM Central Time
Teleconference only
Attendees:
David Haugen
Lisa Wichterman
Dianne Hagen
Tracy Wry
Jessica Evans
Michelle Dinkins
Julie Saba
Pete Anderson
Brenda
Darryl Ross
Megan Green
Jessica Evans
Deb Sommer
Donald Bechtle
Mary Hall
Sonya May
Leslee Smithers