Claims Payment Systemic Errors

  • Ohio Managed Care Plans are required by the Medicaid Managed Care Provider Agreement (Appendix K, Claims Payment Systemic Errors) and the MyCare Ohio Provider Agreement (Appendix C, Plan Responsibilities) to communicate to providers when claims adjustments are processed for incorrectly underpaying, overpaying, or denying claims when certain criteria are met. Cases that meet these criteria are defined as Claims Payment Systemic Errors, or CPSEs.

    • Starting Feb. 1, 2023, as part of the Next Generation Medicaid Program, Molina will post a linked monthly report below to meet this requirement.
    • Prior to Feb. 1. 2023, Molina will continue to post a linked bi-monthly report below to meet this requirement.

     

    All prior monthly reports are archived on this site. If you have any questions after reviewing these reports, please reach out to your Provider Services Representative.

    Links below are in PDF Format (icon PDF)

    2024

    icon PDF September 2024 CPSE Report

    icon PDF August 2024 CPSE Report

    icon PDF July 2024 CPSE Report

    icon PDF June 2024 CPSE Report

    icon PDF May 2024 CPSE Report

    icon PDF April 2024 CPSE Report

    icon PDF March 2024 CPSE Report

    icon PDF February 2024 CPSE Report

    icon PDF January 2024 CPSE Report

     

    2023

    icon PDF December 2023 CPSE Report

    icon PDF November 2023 CPSE Report

    icon PDF October 2023 CPSE Report

    icon PDF September 2023 CPSE Report

    icon PDF August 2023 CPSE Report

    icon PDF July 2023 CPSE Report

    icon PDF June 2023 CPSE Report

    icon PDF May 2023 CPSE Report

    icon PDF April 2023 CPSE Report

    icon PDF March 2023 CPSE Report

    icon PDF February 2023 CPSE Report

    icon PDF January 2023 CPSE Report

     

    2022

    icon PDF November 2022 CPSE Report

    icon PDF September 2022 CPSE Report

    icon PDF July 2022 CPSE Report

    icon PDF May 2022 CPSE Report

    icon PDF March 2022 CPSE Report

    icon PDF January 2022 CPSE Report

     

    2021

    icon PDF November 2021 CPSE Report

    icon PDF September 2021 CPSE Report

    icon PDF July 2021 CPSE Report

    icon PDF May 2021 CPSE Report

    icon PDF March 2021 CPSE Report

    icon PDF January 2021 CPSE Report

     

    2020

    icon PDF December 2020 CPSE Report

    icon PDF November 2020 CPSE Report

    icon PDF October 2020 CPSE Report

    icon PDF September 2020 CPSE Report

    icon PDF August 2020 CPSE Report

    icon PDF July 2020 CPSE Report

    icon PDF June 2020 CPSE Report

    icon PDF May 2020 CPSE Report

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  •  2023 CPSE Report