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Mass Adjustment for Certain $115 Add-on Claims - IHCA

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Mass Adjustment for Certain $115 Add-on Claims

Posted Nov 16, 20201 min Read

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The Indiana Office of Medicaid Policy and Planning (OMPP) recently identified a claim processing issue that affects claims for the temporary $115 per resident daily add-on. The claims system did not apply the $115 add-on when the member had a cost-sharing amount due on the same claim. The system has been corrected and affected claims will be mass adjusted.

Providers should see the adjusted claims on Remittance Advices (RAs) beginning December 16, 2020, with internal control numbers (ICNs)/Claim IDs that begin with 52 (mass replacement non-check related).

For claims that were underpaid, the net difference will be paid and reflected on the RA.  Click here for more information.

About the Author

Elizabeth Eichhorn, Director of Reimbursement Policy and Payor Affairs