Mismatched clearinghouse submitter IDs, system failures and missing enrollment documents are top reasons claims are being rejected or processed slowly. CMS announced it lifted its claims hold, which was in place to allow MACs to update their systems to reflect the temporary conversion rate, on Jan. 17 and immediately started paying claims. However, many providers see this as no more than the saying, "the checks in the mail".
Some providers haven’t been paid since November 2011 as a result of such issues. And even though practices are reaching out to their MACs, many get “little to no information” except being told the blame lies with the clearinghouses or software vendor.
Reason's why claims are being rejected:
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