DOH Issues Delay Reason Code 15 (Natural Disaster) Guidance on Medicaid Billing 

According to the state Department of Health (DOH), during the state of emergency or until the issuance of subsequent guidance by DOH “prior to the expiration of such state disaster emergency declaration, claims that would normally have been required to be submitted during the State of Emergency exceeding the timely filing limits may be submitted electronically using Delay Reason 15 (Natural Disaster/State of Emergency).”


DOH states that additional documentation for Delay Reason Code 15 does not need to be sent at this time. Upon claim review, if the normal claim submission timeframe does not fall within the state of emergency, documentation may be requested to support the use of Delay Reason Code 15.  


HCA members with general questions for Medicaid claims submission should be directed to DOH at 1-800-343-9000. Questions on specific claims that are pended for review should be directed to DOH’s Bureau of Medical Review, Pended Claims Unit, at 1-800-342-3005 (option 3).