Be kind to your doctor's office, they're having a bad day (courtesy MDHHS)

State reimbursement is doing what you'd expect state-run health insurance to do, and life at a thousand physician offices just got more complicated.

Today's MDHHS email.

All Providers,

MDHHS is currently experiencing a higher-than-normal volume of claim suspends. We are diligently working to process the claims and ask providers to allow additional time for the claims to be adjudicated. 

To determine why a claim has suspended review the CARC and RARC codes appended to the suspended TCN.

Providers with additional questions should contact Provider Support at 1-800-292-2550 or by email at ProviderSupport@Michigan.gov  

An entire section of the MDHHS website is devoted to Doing Business with MDHHS. From the Billing and Reimbursement file:

"The former MDCH explanation codes are obsolete and are not used for claim adjudication within CHAMPS. Providers must instead refer to the HIPAA compliant Claim Adjustment Reason Codes (CARC) and Remittance Advice Remark Codes (RARC) available through the CHAMPS claim inquiry process or included with the remittance advice. Please visit the Washington Publishing Company website for a complete listing and description of the HIPAA CARC and RARC codes at www.wpc-edi.com/codes."

https://www.michigan.gov/mdhhs/doing-business/providers/providers/billingreimbursement/explanation-codes