If you need to change the information on a paid claim or request reconsideration on a denied claim, you must submit an adjustment request. The request must be received within 90 days of the date on the Medicaid remittance advice. There are certain exceptions to this time limit, such as for claim denials related to third-party resources.
Adjustment requests must be clearly marked and contain the following information: Client ID, provider ID, date of service, Medicaid claim number and the reason the adjustment is being requested. A copy of the Medicaid remittance advice is preferred. A new claim should never be submitted as an 'adjustment request' or to correct a claim that has been reported on your remittance advice. For complete instructions, see 471-000-99.
Approved claim adjustment requests that result in payment changes are reported on the Medicaid remittance advice. Denied claim adjustment requests are reported on a paper “Medicaid claim adjustment denial notice" sent to your pay-to address.
To make sure we received your adjustment, you may call Medicaid claims customer service at (877) 255-3092. Remember to check before the 90-day time limit expires.