State Claims Denials for MAFDN Coverage

Recently, there was a system error at the state level which resulted in State Claims being denied or recouped when billed upstream for consumers with retro MAFDN (Family Planning Medicaid) coverage.

Partners will continue to enroll consumers with MAFDN Medicaid coverage in the State Benefit. Plan. Please note:

• If you have had claims reverted due to retro MAFDN, please resubmit the claims.
• If you have received a denial due to enrollments, you must complete a note in AlphaMCS for Partners’ Enrollment and Eligibility to retro the authorization.

If you have questions specifically related to enrollment, please contact Sandy Palfreeman by emailing spalfreeman@partnersbhm.org. Please direct all other questions related to this Provider Alert to your Provider Account Specialist.