Medicaid denials and solutions

Medicaid denial codes.

0253 Recipient ineligible for DOS will pend for upto 14 days

It means, As of now patient is not eligible but patient may get enrolled with in 14 days. If its they will process or we need to bill patietnt.

0482 Duplicate

0660 Other ins paid more than medicaid allowable

Take w.o secondary balnce

Medicare coverege is present

Get the medicare id and file the claim

4044 procedure code/age conflict

Check the CPT

2504 Recipient has other insurance coverage on Medicaid third party file

Find Medicaid HMO and file the claim

Pricing adjustment. Max fee pricing applied

Contractual adjustment. write off

Claim is pending. Claim will appear as paid or denied on a futre remittance voucher

Wait for another EOB from Medicaid

Link which are simillar to

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