LEA Claims Processing Issues
As of July 1, 2006, the LEA claims processing system has been modified to reflect the new LEA billing codes and policy changes. The California Department of Health Care Services (DHCS) has identified errors in the claims processing system which may cause claims to be inadvertently denied or incorrectly paid to LEA providers. DHCS is currently working with Electronic Data Systems (EDS) and Fiscal Intermediary - Contracts Oversight Division (FI-COD) to resolve these issues. The link below provides a current summary of claims processing issues and status of resolution.
The link below is an EDS Erroneous Payment Correction (EPC) letter to LEA providers notifying LEAs that claims will be automatically re-processed for claims that were overpaid or underpaid due to claims processing system issues.