Skip to Main Content
Ready to renew your Medicaid coverage? Explore our step-by-step guide to Medicaid renewal. Here's how
Ready to renew your Medicaid coverage? Explore our step-by-step guide to Medicaid renewal. Here's how

MCS SUNSETTING AND REMINDERS ON TIMELY CLAIM FILING LIMITS, COMPLAINTS, AND DISPUTES

Date: 12/22/22

As previously communicated, Meridian migrated to a new claims processing system on July 1, 2021. All claims for dates of service on or before June 30, 2021, have continued to process in our legacy system known as MCS. Timely filing limit for MCS applicable claims expired December 31, 2021*. Consequently, Meridian will retire the MCS claim system effective February 28, 2023. Providers should be mindful of the guidelines outlined below if seeking resolution for any outstanding MCS applicable claims.

What Does This Mean?

Claim projects and disputes for dates of service on or before June 30, 2021, that are currently in motion will continue until resolution is complete. Any new dispute submitted is outside the dispute time frame. As such, the dispute portal for claims DOS before July 1, 2021, will be closed, and new claim disputes will not be accepted after the February deadline. This includes settlement requests that have not already been reported.

Claims submission, reconsideration, and dispute timeframes

Effective January 1, 2023, paper claim and other documents will no longer be accepted at the address below as the timely filing and dispute time for claims processed in the MCS system has passed:  

Meridian
Attn: Claims Department
1 Campus Martius, Suite 720
Detroit, MI 48226

If a provider has extenuating circumstances that would require paper submission of claims, please reach out to Provider Relations. Representatives will provide instructions on submission.

Questions?

  • Contact Provider Relations
  • Applicable providers may contact their assigned Meridian Provider Engagement Administrator (PEA) or Provider Network Support Specialist II (PNSII)
  • Providers without an assigned PEA or PNSII may submit questions via the Provider Relations Intake Form
  • The Provider Relations team assigned to the provider’s demographic region will respond within 2-3 business days

Per the Meridian Provider Manual:

  • All claims are required to be submitted within 180 days from the date of service
  • Reconsiderations and disputes should be filed within 90 days of the provider’s Electronic Remittance Advice (ERA) / Explanation of Payment (EOP) date

We are committed to resolving claim issues and ensuring payment in accordance with the Department of Healthcare and Family Services’ guidelines, national correct coding, and contract arrangements. Additionally, we offer our providers multiple options to have claims reviewed and reconsidered prior to the initiation of a formal dispute.

Formal claim dispute

When providers delay in notifying us of an issue, a review of aged claims may not be able to be accommodated. In those instances, a formal claim dispute may be filed via our secure provider portal or mailed. Please see the Meridian Provider Manual for more details.

*Only applies to first time claims for dates of service on/prior to June 30, 2021.