How do we get adjustment paper claims paid from 2008 (legacy system) and from May 2009 (NewMMIS)?
The process has not changed for claims that are over one year beyond the date of service. You must follow the previously established guidelines for requesting a final deadline appeal (see All Provider Bulletin 186). If a previously paid claim is within one year, the provider can submit an adjustment according to the appropriate guidelines for the type of submission. For electronic claims, review the 837I Companion Guide for detailed loop/segment information. For direct data entry (DDE), refer to the e-Learning tool available on the Provider Online Service Center. For paper claim submissions, please refer to the Billing Guide for the UB-04 on the MassHealth Web site. Please note that if the claim was processed in the previous (legacy) system, then the provider must submit a paper adjustment to correct an incorrectly paid claim.
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