Remittance Advice Alerts/PROMISe Banner Pages
Subject: ESRD Transitional Drug Adjustment from Medicare
Banner Date: April 12, 2019
Cycle: 42
Provider Specific: 102016236-0002, 102286948-0006, 001101797-0003, 001833233-0003, 100748293-0136, 102707271-0001, 100748293-0058, and 100735393-0010
Claim Types: All
Subject: ESRD Transitional Drug Adjustment from Medicare
Attention, DME providers who have received a Transitional Drug Adjustment from Medicare for Calcimimetic medications Sensipar and Parsabiv for the period covering January 1, 2018 through July 4, 2018. See mlnconnects® dated 7/5/18 for details.
If you have not already done so, the Department of Human Services recommends you adjust the original paid claim. Instructions for completing a claims adjustment are located in the provider handbook. See link below:
The Department will allow you to adjust claims affected by Medicare’s rate adjustment beginning April 16, 2019 and ending May 8, 2019. The Department is suspending timely filing rules during this period only for these claims.
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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