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MedicaidAdministrativeMedium impact

Claims Reconciliation due to Vital Statistics System Updates

Maryland Medicaid·MD·General Provider
Effective date
Not stated
We identified it
Jun 25, 2026
Days to comply

Summary

Maryland Medicaid has identified system errors where participant date-of-death records in the vital statistics system caused unexpected claims denials. Maryland Medicaid is reviewing and reprocessing affected claims over the next few pay cycles. Providers impacted by these claim adjustments may file appeals or contact Maryland Medicaid for assistance.

Action Required

Action needed
REQUIREMENTS: Within the next few pay cycles: (1) Billing team should monitor explanation of benefits (EOB) and remittance advice for claims that were previously denied due to date-of-death system errors—these should be automatically reprocessed by Maryland Medicaid. (2) Reconcile accounts receivable to identify claims that were denied and track which ones are reprocessed. (3) If claims are not reprocessed automatically, file an appeal in accordance with COMAR 10.09.36.09 or contact mdh.hcspecialproject@maryland.gov for further assistance. (4) Ensure all billing staff are informed of this transmittal so they understand why previously denied claims may suddenly post as paid. No immediate workflow changes required, but proactive monitoring and reconciliation are essential.