Highmark processed Medicare claims with 21% cut

by CHARLES FIEGL on Apr 23, 2010

The Medicare Administrative Carrier (MAC) Highmark is reporting they processed Medicare claims with a conversion factor using the 21% sustainable growth rate (SGR) cut.  Initially, Highmark announced no claims were processed at the reduced rate. The MAC now says the cut went through because of an "internal system error."

"Systems corrections have been made, and claims paid at the incorrect -21% fee will be reprocessed automatically," Highmark says. "[The MAC] plans to continue releasing held claims on a first in first out basis, which will process with the correct fee schedule."

The error effects claims with dates of service from April 1 through April 7.  

Highmark is the MAC for Pennsylvania, Delaware, Maryland, New Jersey and the District of Columbia metro area.

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