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Bulletin ID- No. 22 - The Resolution and Submission of Same-Day Claims-aka Duplicate Claims


Wednesday, February 7, 2007

The District of Columbia (District) Department of Mental Health (DMH) decided to reimburse providers for claims for services rendered on the same day that were submitted for payment but were rejected as duplicate claims. For these claims to be eligible for payment the claims must be proven to fit in this category and for dates of service during fiscal year 2006. To prove that these claims are not duplicates providers must submit service like records that show the claim as part of a set of services provided on the same day in accordance with MHRS standards, but were submitted separately from that other claims.

Please note: For claims for services rendered in fiscal year 2007, same-day claims must be rolled up. If submitted unrolled, all first same-day claims, if appropriate, will be adjudicated for payment and all second plus same-day claims will denied.