Effective 6/1: Claim Denials for Invalid Data

Date: 02/23/17

Effective June 1, 2017, claims submitted with invalid or unclean data elements will result in denial of the entire claim. All claims submitted to Superior must have the required, valid data elements as applicable on each line of a claim in order for the claim to be considered for payment.

Examples (but are not limited to):

• If required National Drug Code (NDC) data elements are missing or invalid for a procedure code on a claim line, the entire claim will be denied, not just the service line missing the NDC data.
• If a procedure code (CPT or HCPCS) is submitted on any line of the claim, it must be a valid code for the date of service billed or the entire claim will be denied.

For any questions, please contact your local Account Manager or call Provider Services at:

• 1-877-391-5921 (STAR, CHIP, STAR Kids, STAR+PLUS, STAR+PLUS MMP, Medicare Advantage)
• 1-866-439-2024 (STAR Health)