Providers who see patients covered by EBMS–PEHT may have noticed that claims have been denied or processed incorrectly since the plan transitioned from Aetna on July 1, 2026.
We were notified last night that EBMS identified an error in their system setup that caused claims to be processed incorrectly. EBMS will reprocess all affected claims and expects to complete this by the end of October.
What providers need to know:
- No action is required at this time. There is no need to resubmit or appeal affected claims; EBMS will reprocess them automatically.
- Allow several weeks for reprocessing. Updated determinations should appear on your remittances as claims are completed.
- If affected claims have not been reprocessed by the end of October, please contact our office and we’ll assist with follow-up.
We will share further updates as soon as we receive them. Thank you for your patience.