The Claims Resolution Matrix is to be used as a reference tool to troubleshoot rejected institutional and professional claims that have been submitted electronically (i.e., submitted via 837I/837P transaction).

The matrices have been updated to reflect a recent change:

All non-migrated claims with dates of service on or before September 30, 2015, will reject on a 277CA transaction if timely filing rules are not satisfied.

This new rejection has been added to our Institutional and Professional Claims Resolution Matrix documents, which can be found on the Trading Partner Business Center.

Note: Providers will continue to receive timely filing denials on their Provider Explanation of Benefits (professional) or Provider Remittance (facility) for migrated claims.

If you have any questions regarding these updates, please contact your Provider Partnership Associate or Network Coordinator.