Error reported by WPS/GHA might have nationwide ramifications.
Medicare Administrative Contractor (MAC) WPS GHA today confirmed that an enhancement to its Fiscal Intermediary Shared System (FISS) caused erroneous additional documentation request (ADR) letters to be sent to providers.
In a posting to its website, WPS GHA reported that the error occurred Aug. 6, but its system was updated on Aug. 17, adding that ADRs now are “ordering appropriately.” WPS GHA is the Part A MAC for regions J5 and J8 and include providers in Idaho, Kansas, Missouri, Indiana, Mississippi, and Nebraska.
“Providers should monitor ADRs generated between August 6, 2018, and August 17, 2018,” WPS GHA said, noting that it is “working with the FISS maintainers to identify the claims that have received an erroneous letter, and WPS GHA will override those claims manually.”
Ronald Hirsch, MD told RACmonitor that he hopes hospitals will not expend too much effort sending out charts that were requested in error.
In the FY 2026 Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) proposed rule, the Centers for Medicare &
Last August, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) reported its findings on a review of certain MS-DRGs
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