most common mistakes - Filing adjustment form

The most common mistakes that are made when filing adjustments are these:

• Incomplete or invalid MID information or ICNs
• Multiple ICNs on the same form
• Unspecified or too-general reason for the adjustment request
• Missing copy of the RA related to the request
• Missing reference to the original ICN, or use of a denied adjustment ICN
• A partial payment or partial recoupment number is not referenced as the original ICN
• Filing the adjustment after the 18-month time limit
Note: If an adjustment is not filed until the 17th month from the date of service, the original claim may no longer be available in the system for adjustment. Submit adjustments as soon as possible so they can be processed within the 18-month time limit.
• Missing required documentation (Medicare vouchers, medical records, operative records, etc).
• Referencing the NPI on the adjustment request

Note: This form requests the MPN in the blank specified for Provider Number.

Posted in: adjustment form