ODP is processing gross adjustments for paid promise claims with a date of service from January 1, 2022 thru February 28, 2022. These adjustments will be visible on provider Remittance Advices on June 27, 2022 at the provider’s highest billing service location. The adjustments will reflect the difference in the current (effective January 1, 2022) fee schedule rates and the previous fee schedule rates (which were still active in HCSIS/promise thru March 1, 2022) times the number of service units billed and paid as of 5/30/2022.
Providers are encouraged to review their payment/trade files for the relevant time period in order to validate the gross adjustment amounts. Instruction on how to download payment files from promise can be found in the HCSIS learning management system (LMS) under the heading “ODP-ID/A: FM300J Payment File”.