Jefferson Health Plans recently received an unusually high volume of claims through our clearinghouse, SDS. These claims were submitted to SDS through another trading partner and included a high volume of duplicate claims. Certain claims were inadvertently adjudicated to pay, resulting in duplicate payments being made to providers. As you know, our participating agreements and provider manual call for our recoupment of these incorrect payments.

We will begin retracting the duplicate payments beginning the week of August 12, 2024. We expect the full recovery effort to be completed by September 17. You will be able to see the impacted claims on your weekly remittance advice. Thank you for your kind attention to this matter.