Changes to misdirected claims processing

October 2026

We're updating how misdirected claims are handled. Previously, claims submitted to us in error were forwarded to the health plan for processing. Going forward, these claims will no longer be forwarded.

If a claim is sent to the wrong payer, you will receive an Explanation of Payment (EOP) identifying the claim as misdirected and advising you to submit it to the correct payer.

• New EOP code: REJMDVS
  • Service is not payable under primary eye care benefits. Submit claim to plan for processing.

If you receive this code, please resubmit the claim directly to the appropriate health plan to avoid processing delays.