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If your H0015 / IOP claims are denying for CO-197 / No Prior Authorization, normally this code does not require auth, but H0015 TG/PHP does.
After working with a rep at Humana Healthy Horizons to help get issues resolved, they had a system update in January that has created a glitch between these two codes and have since been denying claims that should not be denying.
The issue has been updated in their most recent CPSE report (Claims Payment System Error) that comes out on the 15th of each month.
This means that they are aware and working on the issue to get it fixed.
The only option is to continue to submit these claims even though they will deny. When the system error has been fixed it will connect back to all of the claims that are connected to the CPSE and reprocess.
It is good to keep your list with the claim information, but getting reimbursement may be tough with this issue, as these claims will not be paying in the meantime and will increase the denial rate.