June Maintenance Update: Remittance Advice Report Changes

To All Agency Administrators and Billing Staff,

We are updating the Remittance Advice Report with 6 new fields to improve the tools available for providers to track payment. The Remittance Advice Report can be used by all types of providers to monitor the payment status after a claim comes back from MMIS.  These changes will be implemented in the June 12th 2023 Release.  Please see the changes outlined below.  

For DDA providers only, there will be an additional change to the “Authorized Services Report”.

Section 1: Summary on the Payment Process:  

1. (Daily) Users create activities in LTSSMaryland
2. (Daily besides Friday) LTSSMaryland will generate all activities without exceptions into claims the following morning (between 1 AM - 8 AM) to MMIS for payment
3. (Weekly) MMIS processes claims and sends the adjudication to LTSSMaryland every Saturday
4. (Weekly) Providers are able to see the payment outcomes in two locations:
1. LTSSMaryland Remittance Advice Report (to be updated in June) is available the Thursday or Friday after each Saturday adjudication.  
2. eMedicaid Remittance Advice is available the Monday after each Saturday adjudication.

Section 2: Summary on Adjustment Processes

There are three possible Claim Type values that may be assigned to a claim

1. Original: This is the very first claim to be submitted
2. Adjustment: When an Original or Adjustment claim needs to be adjusted to a new value.
3. Void: When an Original or Adjustment claim needs to be adjusted to the value of 0.  Once voided, future claims will need to be an Original claim.  

Section 3: Remittance Advice Report Updates June Release 

Adding the following fields

1. Original Payment Date: Shows date of original claim payment. Only appears for adjustments/voids
2. Latest Claim Adjusted Date: Appears on the original claim line if an adjustment was made to this claim.  
3. Original Claim ICN: Shows the original claim ICN that was adjusted. Only appears for adjustments/voids.
4. Claim Payment Status: Shows Paid or Rejected
5. Running Total Amount: Adds up all Original and Adjustments made for this particular Date of Service, MA #, Provider #, and Proc Code.  Total of what was paid across all time.  

Total Paid for this RA: Amount paid for the claim on a given Remittance Advice week. 

Authorized Services Report Updates June Release

1. Updating total paid to “Running Total”
2. Adding a “Total Paid per Transaction”
3. Update the Billed Summary only add up unique claims for the total amount

LTSSMaryland’s Mission

“To provide an online solution to coordinating Medicaid Home and Community-Based Services across programs.”