Adjustment of Medicare/Medi-Cal Crossover Claims for Outpatient Services for Nov. 2017

The Department of Health Care Services (DHCS) identified a claims processing issue affecting Medicare/Medi-Cal crossover claims for outpatient services. This issue caused some crossover claims to under pay. The issue affected claims for dates of service from January 1, 2016, through September 30, 2016. No action is required on your part. Conduent will adjust the affected claims. These adjustments will appear on Remittance Advice Details (RAD) forms beginning October 19, 2017, with RAD code 0824: Price correction, after erroneous quantity cutback.