Claim issue | Description of issue | Affected provider type | Call to action |
|---|---|---|---|
Supportive living facility claims billed per the days (DA) option | Claims submitted using the DA option currently are not being processed for revenue code 240. | Supportive living facility | Provider should rebill a corrected claim using the UN (unit) option for any denied claims. Provider should submit a new electronic claim, submission initial claims using the units option. |
Services not allowed according to provider’s contract | Claims are denied (code 60C) when Leave of Absence codes are billed with revenue code 240 during the covered days. | Facility | Humana will correct the issue and reprocess claims as quickly as possible. Humana will notify providers when the issue is resolved. |
Multiple months accepted for homemaker services (S5130) | Homemaker services (code S5130) claims are denied (code 338) in error when multiple months are billed on the same claim form. | Long-term services and supports (LTSS)—atypical | Humana will correct the issue and reprocess claims as quickly as possible. Providers should rebill corrected claims for separate months for any denied claims. For new claims/services, providers should bill 1 month per each claim. |
Provider Documents
Illinois Medicaid
Illinois Medicaid Illinois Medicaid Provider Notices and Updates Illinois Medicaid Provider Documents Illinois Medicaid Provider Training Materials - Illinois Medicaid Provider Long-Term Services & Support