In educational meetings conducted earlier this year across the state, AdminaStar encouraged all Part-B ambulance providers to resubmit denied and appealed claims for additional review and reconsideration for payment. AdminaStar, with HCFA's approval, agreed that for a limited time they would reimburse providers the 10% automatic reduction on denied and appealed claims that had been originally submitted on a timely basis but had been hung up in the 7-12 month appeals backlog.

KAPA has been informed by AdminaStar that all claims for dates of service exceeding one year but in which the original claim had been previously submitted within the required 12 month time frame MUST be submitted to AdminaStar no latter than the close of business on May 30, 2001 in order to qualify for reimbursement of the automatic 10% reimbursement reduction.

AdminaStar is creating reports to identify the claims that qualify for reimbursement of the automatic 10% reduction. They will then furnish the Part-B ambulance providers with a listing of all claims that have qualified for the 10% repayment and generate a manual check. AdminaStar anticipates that this process will occur on or about June 30, 2001 for Kentucky's Part-B providers. This will be a one time only process.

Any resubmitted claims received after May 30, 2001 that are more than 12 months after the date of service will be subjected to the automatic 10% reimbursement reduction and the 10% reduction will not be refunded regardless of the original filing date.

Part-B ambulance providers with questions are directed to contact Lindy Lady of AdminaStar's Provider Relations. Her telephone number is (502) 423-2292 and her email address is Lindy.Lady@Anthem.com.

In other news, KAPA is happy to announce that AdminaStar has agreed to provide KAPA and providers with a quarterly listing of the 10 most frequent reasons for ambulance claim denials. In order to protect confidentiality, this information will not identify any specific providers and will be general in nature. With this information, providers may continue to fine-tune their billing and documentation training for their individual services.