RHC Claims with CG Modifier - Resolved 08/02/23

Provider/Supplier Type(s) Impacted: Rural Health Clinic (RHC 71X claims)

Reason Codes: N/A

Claim Coding Impact: N/A

Description of Issue: RHC claims paid under all-inclusive rate and billed with CG modifier may have applied coinsurance incorrectly. This issue impacted claims processed between 05/15/23 - 06/12/23.

Noridian Action Required: Noridian will initiate mass adjustments.

Provider/Supplier Action Required: No provider action is required at this time.

08/02/23 - No provider action is needed to correct the claims. Providers should review remittance advices for reimbursement changes.

Proposed Resolution/Solution: The system logic was corrected on 06/12/23.

07/06/23 - The adjustments are scheduled to start on or around 07/13/23.

07/19/23 - This is a correction to the above date. Adjustments will start on or around 07/31/23.

08/02/23 – The shared system maintainer initiated the adjustments.

Date Reported: 06/15/23

Date Resolved:08/02/23

Last Updated Oct 17 , 2023