Understanding the Provider Adjustment Details of Remittance Advice

Do you need more resources and assistance in understanding the provider adjustment details section of the remittance advice?

Noridian’s Remittance Advice Field Descriptions and the Remittance Advice Tutorial have both been updated to provide guidance for those fields, specifically the WO PLB Reason Code used for offsets. View these today for more information.

WO PLB Reason Code Description

  • Offset: As a result of a previous overpayment (A/R accounts receivable). Used to recover previous overpayment. A reference number (the original ICN and Medicare ID) is applied for tracking purposes.

    Important Note: In HIGLAS when two or more providers are affiliated and have the same Tax Identification Number (TIN), payments may be withheld from one provider (PTAN) to collect another provider's (PTAN) overpayments.

    When money is taken back by TIN, if supplier cannot determine the PTAN who money is being taken back on, call the Provider Contact Center for your Jurisdiction to obtain that information.

    Example: Supplier 123 PTAN in California receives remittance advice. An offset is taken back from supplier 345 PTAN in Florida. Both suppliers under same TIN but supplier 123 is unable to locate account in their accounts receivable to balance account. Contact the Provider Contact Center to obtain this information.

 

            Last Updated Thu, 21 Oct 2021 15:57:42 +0000