Claim Status showing 0.00(REFLM) after I received the check, but Remittance is correct. Normal?
Hi everyone,
I hired a medical biller to handle my Humana DME claims. Initially, everything was working fine. In Availity Claim Status, I could see the actual paid amounts from Humana.
Later, I received the physical check (haven’t deposited it yet). However, now when I check Claim Status, I’m seeing something strange:
A line with REFLM showing $0.00
Allowed amount showing -$1,000 (reversal)
Then another line showing +$1,000
The Claim Status is now showing $0.00 in the paid/allowed amount, and the claim is marked as FINALIZED. But when I check the Remittance Viewer, it shows the correct check number, claim details, and the actual payment amount — everything matches the physical check I received.
The check was issued weeks ago (around mid-June), but the claim only got finalized a few days ago (when I received the check).
My question is:
Why is Claim Status showing $0.00 and this reversal pattern, while the Remittance Viewer and the actual check are completely correct? Is this normal after Humana reprocesses or re-issues a payment?
Has anyone experienced something similar with Humana (especially Medicare Advantage DME claims)? Any idea what’s going on here?
Thanks in advance!