Remittance Advice Alerts/PROMISe Banner Pages
Subject: Fee-for-Service Relative Weight Adjustments
Banner Date: April 6, 2018
Cycles: 41, 42, 43
Provider Type/Specialty: 01/010
Claim Types: I and A
 
Subject: Fee-for-Service Relative Weight Adjustments
 
This remittance advice contains claim adjustments initiated by the Department of Human Services (The Department) to reprocess previously paid acute care general hospital claims using APR DRG grouper version 35 and the associated Fee-for-Service (FFS) Relative Weights implemented March 15, 2018 as stated in the Remittance Advice (RA) banner pages published in cycles 35, 36, and 37 in March 2018.
 
The APR DRG v35 FFS Relative Weight Mass Adjustments include claims with discharge dates of October 1, 2017 through March 15, 2018 and can be identified on this RA by ICN range 5218093348082 through 5218093378906.
 
Please note that reprocessing of the claims does not guarantee payment. If there are other issues or billing errors associated with these claims, you will receive a denial specific to those issues or errors.
 
Questions related to your remittance advice, including the adjustment mentioned above, should be directed to Provider Inquiry at 1-800-537-8862, Monday through Friday, 8:00 am to 4:30 pm.
 
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