Adjustment Processing. The MIS adjustment processing function must have the capabilities to: 1. Maintain complete audit trails of adjustment processing activities on the claims history files. 2. Update provider payment history and recipient claims history with all appropriate financial information and reflect adjustments in subsequent reporting, including claim-specific and non- claim-specific recoveries. 3. Maintain the original claim and the results of all adjustment transactions in claims history; link all claims and subsequent adjustments by control number, providing for identification of previous adjustment and original claim number. 4. Reverse the amount previously paid/recovered and then processes the adjustment so that the adjustment can be easily identified.
Appears in 4 contracts
Samples: Medicaid Managed Care Contract, Medicaid Managed Care Contract, Medicaid Managed Care Contract
