Article Detail - JF Part A
Incarcerated Claim Denials
Provider/Supplier Type(s) Impacted: All
Reason Codes: U538H
Claim Coding Impact: Not applicable.
Description of Issue: Noridian is aware of an claims processing issue with claims potentially denying for incarcerated status when the beneficiary does not have incarcerated record(s). Claims denying incorrectly with reason code U538H for "SERVICES BILLED WHILE BENEFICIARY IS INCARCERATED."
Noridian Action Required: Noridian continues to work with the shared system maintainer for a resolution.
Provider/Supplier Action Required: No action is required at this time.
Proposed Resolution/Solution: The shared systems maintainer is working to resolve the issue.
09/20/24 – No updates. Noridian is monitoring the issue and will provide updates as they are available.
09/05/24 - No updates. Noridian is monitoring the issue and will provide updates as they are available.
Date Reported: 08/15/24
Date Resolved:
