Billing Beat

Correct Excessive Copay on Multi-Month Claims, TR 50671

November 27, 2017

The issue where the system was not correctly calculating copay totals for each month that is limited by the Deficit Reduction Act Maximum (DRA Max) out-of-pocket expenses when the dates of service on the claims spanned multiple months has been corrected. Affected claims will be reprocessed. No provider action is needed. 

Source: https://content.govdelivery.com/accounts/MEHHS/bulletins/1c5a53a

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