Published on August 14, 2013
Update on Remittance Issue: The clearinghouse has been notified by North Carolina Medicaid of the following remittance updates:
• Reason Codes Specific to Contractual Adjustments
- Remittance may contain adjustment reason codes limited to specific contractual requirements (CO45), which may cause providers to encounter issues posting remittance to the detailed rejection reason included on the Explanation of Payment found in NCTracks. More detailed adjustment reason codes are required. The payer will address this issue by the end of the month. In the interim, the payer will send CO45 adjustment reason codes for denied claims to keep remittances balanced to the Submitted or Billed charges.
• Deductions for Patient Responsibility
- Remittance is being returned with negative dollar values due to adjustments made for patient responsibility. This is causing balancing issues and delays. The payer will send the positive patient payment amounts moving forward. This change will be effective by the check write cycle date of 08/20/2013.
We are continuing to work with the payer and will send additional notifications as soon as more information is available.
If you have any questions, please contact Client Services at 1-888-348-8457, option 2.