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Wiki Retro Claim Reimbursement

Thread starter Ahodge20
Start date Nov 11, 2021
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adjustments claim retroactive

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Ahodge20

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Nov 11, 2021

I have been searching and searching for information on how retroactive claim adjustments should be handled by managed care plans. When Medi-Cal retro's the DME supplies or Radiology codes, the effective date went back over 6 months to a year... Is there any guidance or rules on how MCPs are to recoup the overpayment?

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