Are there any claims excluded from the crossover process between WPS and Michigan Medicaid?
A.A3: Yes. The following types of claims will be excluded (not sent to Michigan Medicaid from WPS) from the crossover process: • Totally denied claims; • Claims denied as duplicates or for missing information; • Adjustment claims (referred to as “replacement or void/cancel claims”); • Claims reimbursed at 100 percent from WPS; • Claims for dates of services outside the beneficiary’s Medicaid eligibility begin and end dates.
