Error D8

High Urgency

Specialist Claim Paid at GP Rate

MSP overpaid a specialist claim at the General Practitioner (GP) rate and is now debiting the difference.

Official Description: Debit adjustment of account paid at GP rates.

Follow these steps in order to resolve the error.

Locate the original claim this debit adjustment refers to on your remittance statement.
Verify the referring physician's practitioner number and the referral date submitted on the original claim.
Check if the referral was valid on the date of service. Specialist referrals are typically valid for six months from the date of the first visit.
If the original claim had an incorrect or missing referring physician, submit a Reconsideration request to MSP with the corrected referral information and a letter of explanation.
If the patient did not have a valid referral, this debit is correct. Reconcile the account. Do not resubmit the claim.
If you believe the debit was made in error and the original referral was valid, contact the Teleplan Service Desk for clarification at 604-683-7151.