Attention: MCOs Change in Outpatient Encounter Claim Processing

It has come to our attention that outpatient encounter claims are denying with Explanation of Benefits (EOB) code 00472 - SUSPECT DUPLICATE-OVERLAPPING DATES OF SERVICE, INSTITUTIONAL. This edit was not intended to apply to outpatient encounter claims.

On Oct. 7, 2018, the NCTracks system was updated.  The effective date of the change is July 1, 2013. No reprocessing of previously denied outpatient encounter claims is planned.