Horizon Wrong Payee Issue- 5010 Problems Persist

Members are urged to review payments from Horizon, beginning in 2012, to ensure that payments went to the correct tax identification number. Last year several members reported that Horizon was remitting payments to the physicians’ social security numbers, instead of the practices’ tax identification numbers.Horizon was contacted regarding our concerns, including possible tax implications. Horizon indicated that the wrong payee issue was a result of the 5010 transition. The County and State Medical Societies was assured, on several occasions, that the systems issue was “identified and corrected” and that claims would be reprocessed.

Recently, BCMS and MSNJ was made aware that the issue is ongoing for some member practices and has resulted in continuing incorrect payments, corrections, and recoupments. We are concerned that many members may not be aware of the issue, due to EFT payments. We advise members to review the “Payee ID” number located at the top of explanations of benefits issued by Horizon, from the beginning of 2012 on, to confirm that payments went to the correct tax identification number. We advise that members review payments from Horizon, from 2012 on, to confirm that payments went to the correct tax identification number. We fear there may be IRS 1099 tax implications for payments sent to the physician’s social security number, when they should be remitted to the practice’s tax identification number. We sent a letter to Horizon again expressing our concern that the issue was not corrected; requesting that Horizon provide us with their plan to rectify the matter and asking Horizon to send notice to all affected physicians.

If you are currently experiencing this issue, please contact the State Medical Society at info@msnj.org and put “Horizon Wrong Payee” in the subject line.


BCMS  will keep members apprised of progress on this issue.