Update on Claims Pended for Incorrect Location

When a claim is received with an incorrect Billing, Rendering, or Attending Provider Location, the claim is pended in NCTracks. This occurs when the provider location submitted on the claim does not match the location(s) in the NCTracks provider record. When a claim is pended for incorrect location, a secure message is sent to the provider's NCTracks Message Center Inbox in the provider portal, with a link to a screen that enables the provider to select the correct provider location from a drop down list. The claim is then released to continue processing. This approach allows a provider to correct the claim, rather than having it deny for incorrect provider location.

However, beginning September 5, if a claim pended for incorrect location is not corrected by the provider within 60 days, it will auto-deny. The provider will then need to resubmit the claim with the correct provider location. This will keep the claims from remaining pended indefinitely. The EOBs associated with the claims denied for incorrect location are:

4525 - Billing Locator Code Cannot Be Derived
4526 - Rendering Locator Code Cannot Be Derived
4527 - Attending Locator Code Cannot Be Derived

Any claims that have already been pending for incorrect location for 60 days or more will auto-deny this weekend.

For further information regarding the process of correcting claims pended for incorrect location, see the May 27 announcement on the Provider Portal. (See link below)

The User Guide and FAQs related to correcting claims pended for incorrect location have also been updated. (See links below)