This denial reason indicates one of the following:

1.     Medicare has received a final claim, and no RAP exists; or

2.     One of the following fields on the EOE do not match to the RAP

a.     the HIPPS code

b.     the line item date for the HIPPS code

c.     the Statement From Date

d.     the Admission date

e.     the Provider number

Click here for details on Reason Code 38107.

Suggestions to resolve this denial:

1.     Verify that a RAP has been submitted for the episode:

a.     If a RAP has been submitted, make sure that Medicare has not recouped the payment, due to timeliness of submitting the EOE.  

b.    If there is no RAP, submit the RAP for payment.  Once Medicare pays towards the RAP, you can “update” the claim in DDE.  (See KB article:  Updating a Claim in "T" status)

2.    Make sure that all the required fields match on the RAP and EOE claim.  Make the needed corrections and “update” the claim in DDE.  (See KB article:  Updating a Claim in "T" status)

**Note:  These steps are pertinent to RAPs with dates of service prior to 2021.