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| Introduction |
The Mass Adjustment process is used as a tool for
administrative adjustment of contracted rates. Previously paid amounts are recouped, and then repaid at the
new rate. From
the Health Plans' perspective, the mass
adjustment resembles the Daily Enrollment
Notification process in that it is transaction
driven. The mass adjustment transmission file (HIPAA 820) is
identical to that produced using the Daily Enrollment Notification process. |
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| Schedules |
The
following table outlines schedules for the Mass
Adjustment process.
Processing
requirement |
Schedule |
| Mass adjustment processing |
is normally scheduled after the completion of the
daily roster process as needed.
Health Plans are notified of the
adjustment in writing prior to
processing. |
| HIPAA 820 TCS files |
are downloaded to the AHCCCS Communications
Server and available for extraction by
the Health Plan by 11:59 p.m. on a
weekly basis. |
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| Media |
The Weekly Capitation Notification file (HIPAA
820) is available on the AHCCCS communications
server.
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| Testing |
Weekly Capitation
Notification transmissions must be tested in
coordination with AHCCCS ISD operations staff
prior to production implementation of a new Health
Plan or change in service bureau, or as a result
of changes. Typical testing of file transmissions takes approximately one
week and must be completed prior to implementation
of any new processing arrangement.
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| Reference
documents |
HIPAA 820 Companion Document
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