Nov Industry Notes: Open Claims Issue for Medicare Part B
November 12, 2025
The claims issues log below includes the status of claims processing issues that have been identified. We are actively working with the necessary areas/entities to resolve these issues.
If your claim issue is not identified below, please visit our FAQs page (JH)(JL), to view top inquiries on claim status, claim denials, and other topics.
| Date reported | Providers impacted | Workload impacted | Description/claim coding impact | Proposed resolution/fix/action required | Status |
| 11/11/2025 | JH/JL providers | Claims processing issue causing claim denials. | We have identified an issue with conflicting Medicare Advantage (MA) plan enrollment between the HIPAA eligibility transition systems (HETS) and the claims processing system causing claim denials. | We will start to hold claims from denying for MA plan enrollment. Once the resolution has been implemented, we will adjust impacted claims. | Open |
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