Issue with PROF Claims Received with EOB-Type as HHA Only

[Ashvani goyal]

Hi BCDA Team,

We have encountered an issue where PROF claims are currently being received with the EOB-type populated as “HHA” only.

We observed this issue during this week’s processing cycle. Additionally, we reviewed the data for the past 2 months and noticed the same behavior, where PROF claims are consistently being received with the EOB-type as “HHA” only.

Previously, PROF claims were being received with multiple/appropriate EOB-types based on the claim data. However, we are now observing that all PROF claims are consistently coming through with the EOB-type as “HHA”.

This behavior appears to be impacting the expected claim classification/processing flow.

Could you please investigate whether there have been any recent changes, configuration updates, or mapping modifications related to EOB-type assignment?

Below are a few details for reference:

• Claim Type: PROF

• Current EOB-Type Received: HHA

• Observation Period: Current week process and past 2 months data

• Previous Behavior: Different EOB-types were received appropriately based on claim data

Please let us know if you need any additional claim samples, transaction details, or logs from our side for further analysis.

Thank you for your support.

Best regards,
Ashvani Goyal

[Beneficiary Claims Data API (BCDA) Community]

Hi Ashvani,

We have reached out directly via email. Please let us know if you have not received an email from bc...@cms.hhs.gov.

The BCDA Team