Remittance Advice Alerts/PROMISe Banner Pages
Subject: Fee-for-Service Relative Weight Adjustments
Banner Date: March 22, 2019 through April 9, 2019
Cycle(s): 39, 40, 41
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 36 and the associated Fee-for-Service (FFS) Relative Weights implemented February 28, 2019 as stated in the Remittance Advice (RA) banner pages published in cycles 35, 36, and 37 in February and March 2019.
The APR DRG v36 FFS Relative Weight Mass Adjustments include claims with discharge dates of October 1, 2018 through February 28, 2019 and can be identified on this RA by ICN range 5219077471082 through 5219077493282
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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