Open
Mass Adjustment Tracking Log as of 2/16/2011
Expected
Request Request Batch number of
Number Requestor Date Status Title Number claims Working Notes
ADHOC PLOG 9173 - 100966 - Add Provider 11/17/10: PLOG has come off the closed review and is identified as needing
4084 PLOG 9173 17-Nov-10 Required Specialty 069 to Provider Type 344 a mass adjustment
12/30/10: Received email from Michael L. that update have been completed
ADHOC 102030 - Change Claim Exception to the reference file - mje
4100 Joshua Cohen 22-Dec-10 Required 1700 CTO Disposition P&R 12/22/10: Received memo - mje
PLOG 9412 - Exc 0820 (Timely) is
posting incorrectly on paper, non- 11/10/10: PLOG has come off the closed review identified as needing a MA,
Criteria being xover claims that contain a valid the claims have already been identified via ad hoc. Need to check on status
4085 PLOG 9412 10-Nov-10 Reviewed Medicare EOMB date of claims review - mje
Jeanne Criteria being 101944 - Reprocess claims E7599 1/4/11: Memo was found in Regular Claims processing memos - mje
4103 Cournoyer 01-Dec-10 Reviewed 11/03/10 - 11/22/10 12/1/10: Received memo - mje
Criteria being 1/4/11: Memo was found in Regular Claims processing memos - mje
4104 Anna Bransford 01-Dec-10 Reviewed 101946 - DSH Eligibility for FY2010 12/1/10: Received memo - mje
Criteria being
4106 Susan DeGrand 03-Jan-11 Reviewed 102058 - CoLTS Capitation Reclass 1/3/11: Received memo - mje
PLOG 9114 100732 - Claim
PLOG 9114 - Criteria being Exception 0436 Revision for OPPS
4107 Joshua Cohen 05-Jan-11 Reviewed Project 1/5/11: PLOG has come off the closed review - mje
PLOG 9414 - Criteria being PLOG 9414 101679 OPPS Token
4108 Joshua Cohen 05-Jan-11 Reviewed Biling Pricing Logic 1/5/11: PLOG has come off the closed review - mje
Criteria being 110003 - History ONLY Adjust
4114 Mark Pitcock 06-Jan-11 Reviewed Claims Due to Retro CHIP 1/6/11: Received memo - mje
Criteria being
4115 Virginia Alcon 12-Jan-11 Reviewed 110030 - C.M. System ID 106151059 1/12/11: Received memo - mje
Criteria being 110072 - History ONLY Adjust
4116 Mark Pitcock 13-Jan-11 Reviewed Claims Due to Retro CHIP011011 1/13/11: Received memo - mje
2/8/11: I believe that there was email correspondence that this memo is not
Criteria being 110019 - Activate Codes and Pricing assigned a mass adjustment and may need to be removed from the list - mje
4118 Mark Pitcock 12-Jan-11 Reviewed for Med Frag Waiver 1/12/11: Received memo - mje
Frankie Ann 110226 - McKinley Medical Supply W
4121 Vigil 13-Feb-11 New & B Review 2/13/11: Received memo - mje
2/4/11: Received response from Operations that void will be entered - mje
2/3/11: Jim P. has tested a compound adjustment for TCN needing to be
adjusted, recoupment amounts do not match up, need to email state for
Julie Ann Hill- direction - mje
3938 Clapp 30-Jul-10 Pharmacy 101190 - NCS Void File 072810 1/31/11: Training packet
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Open
Mass Adjustment Tracking Log as of 2/16/2011
2/6/11: Received response from Jim P. that ticket will have be opened to
update edit 4761 to allow management override, this will have to be done
Julie Ann Hill- with any edit that posts that needs to be overridden - mje
3939 Clapp 30-Jul-10 Pharmacy 101191 - NSC Adjust File 072810 2/4/11: Received question on edit posting to adjus
Ready to be
4119 Lori Hansen 28-Jan-11 Submitted 110155 - Void PAK Cap TCN's - TC 1/28/11: Received memo - mje
Ready to be
4120 Lori Hansen 28-Jan-11 Submitted 110156 - Void PAK Cap TCN's - JC 1/28/11: Received memo - mje
Working PLOG 9597 Billing code is not being
Suspended spaced out when there is no
4113 PLOG 9597 27-Jan-11 Claims attending provider on the claim 41102700929 01/27/11 submitted original claim for j Bragg identified by Edna Aragon, CMF
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On Hold
Mass Adjustment Tracking Log as of 2/16/2011
Expected
Request Request Batch number of
Number Requestor Date Status Title Number claims Working Notes
1/19/11: Received response from Programmers, further review for remaining
TCN's is needed - mje
1/18/11: Sent email to Programmers asking for advice on how to proceed -
mje
Completion 101121 - TDOS Adjustment Date of 7/26/10: Received all necessary corrections needed to work claims, work
3929 Miguel Ulibarri 16-Jul-10 Pending-PLOG Death Review 1/1/2007 - 12/31/2009 41020000949 243 claims as
PLOG 9412 - Exc 0820 (Timely) is
posting incorrectly on paper, non- 11/10/10: PLOG has come off the closed review identified as needing a MA,
Criteria being xover claims that contain a valid the claims have already been identified via ad hoc. Need to check on status
4085 PLOG 9412 10-Nov-10 Reviewed Medicare EOMB date of claims review - mje
12/16/10: Received a response from Rosemary to place this MA on hold until
her return from leave - mje
12/6/10: Rosemary has requested a discussion regarding TCN's in the batch -
Rosemary 101306 - Exception 0381 - Rate mje
3998 Medrano 17-Aug-10 On Hold Record Not Found 41027700949 606 10/28/10: Five TCN's were deleted from the batch to be processed with me
2/7/11: Received notification that a new memo was requested for system
change, sent email to Rosemary and Virginia asking if the updated memo
has been sent - mje
10/29/10: This MA will be on hold until modification to system list are
Rosemary completed - mje
4027 Medrano 02-Sep-10 On Hold 101412 - Modifier 59 10/29
1/26/11: Sent email to Programmers to confirm - mje
1/26/11: Had a follow up meeting with the State, questioned outcome of
claims if adjusted - mje
1/19/11: Received adhoc results, only three TCN's dropped as not last in
Resp Needed- PLOG 8377-Logic issues related to chain - mje
3574 PLOG 8377 27-Jul-09 Programmer PLOG 7512 6825 1/18/11: Sent Adhoc re
1/26/11: Had a follow up meeting with the State, was informed that Robert S.
is reviewing if the MA - mje
Response 1/18/11: Sent comprehensive email explain situation that identified MA,
Needed From BH claims paying secondary to asked if MA should proceed or be canceled - mje
3647 System Alert 03-Sep-09 MAD Medicare with a LTC lockin 12/7/10: Per meeting with Ma
1/26/11: Had a follow up meeting with the State, was informed that per Chris
LTC Bureau is to approve if this MA is needed - mje
Response 290492 - Set Exception 0110 to 1/19/11: Received adhoc results, sent to Linda for review, additional adhoc
Needed From DENY for claims type W and X - Void may be required - mje
3771 Chris Pruett 10-Apr-09 MAD batch for claim type X 1/18/11: Sent adhoc request
Page 3 of 4
On Hold
Mass Adjustment Tracking Log as of 2/16/2011
1/26/11: Had a meeting with the State, was informed that Robert S. is
reviewing this MA - mje
PLOG 8882-Exception Code 0436 1/18/11: Completed review of adhoc results and sent email asking for State
Response (PA Required) is not posting for approval to proceed - mje
Needed From Inpatient claims, DRG priced and 12/15/10: Received results, reviewing - mje
3885 PLOG 8882 26-May-10 MAD patient status is 02 12/14/10: Sent u
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