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July 8 2026 CCBHC Action Required Adjust Claims to Report Other Insurance before July 30th
July 8,2026: Attention CCBHC Providers: MDHHS has identified claims when the beneficiary has active Other Insurance (OI) which was not reported on the claim resulting in overpayment. This causes the Qualifying Visit (QV) code line to deny correctly; however, the Prospective Payment System (PPS) code line pays incorrectly, causing overpayments.
Providers have until July 30, 2026, to adjust these impacted claims to report the other insurance information. To find the claims that need to be adjusted review the Remittance Advice (RA) for claims with reason code 22 on the QV code line.
Beginning August 1, 2026, until complete, claims not adjusted, will be voided by MDHHS and can be identified with the claim note “Primary OI not reported resulting in overpayment”.