KMAP Open Claims Resolution Log

The Kansas Medical Assistance Program (KMAP) Open Claims Resolution Log, revised October 26, 2026, documents four open or recently resolved claims processing errors affecting institutional and general provider claims under the Kansas Medicaid Management System (KMMS). CHG0075522 (added 10/5/2026) addresses institutional claims submitted with an NPI at the header level (Other1, Other2, or Attending) rather than the detail level, which were intermittently denied with EOB 9941 (rendering, billing, service facility, or operating physician not enrolled with KMAP on the date of service) in error. The error caused underpayments covering the period 4/4/2022 through 9/1/2026. The system was resolved as of 10/12/2026, with reprocessing completed 10/12/2026. INC0084143 (added 10/26/2026) addresses institutional claims submitted with Occurrence Code 55 that were denied with EOB 4103, citing the NUBC UB-04 Data Specifications Manual requirement that Occurrence Code 55 be present when Patient Status Code is 20, 40, 41, or 42. Those denials were issued in error, causing underpayments from 12/12/2025 through the current date. System status, reprocessing plans, and post-implementation date are all listed as pending. CHG0074791 (added 7/15/2026) addresses Medicare crossover claims. KMAP's system reimbursed crossover claims that carried a Claim Adjustment Remark Code (CARC) for deductible, coinsurance, copay, blood deductible, or psychiatric reduction, but lacked a CARC Group Code of Patient Responsibility (PR), causing overpayments from 4/4/2022 through 8/4/2026. The system correction is resolved; claim adjustments are in progress. INC0082154 (added 8/12/2026) addresses claims for members enrolled in the Tuberculosis Benefit Plan that processed above the state-approved payment amount or paid in error from 1/1/2024 through 9/14/2026, causing overpayments. The system was corrected and reprocessing is complete as of 9/14/2026. A separate portal display issue (INC0059401) affecting modifier-specific coverage criteria in the KMAP Public Portal Search by Procedure tool was also corrected as of 8/4/2026, with no claims reprocessing required.