PDF Version
TO: Attribution Providers
Under the
ACHN program, the Medicaid Agency provides a listing of attributed recipients
to providers each quarter after the attribution process via the Quarterly
Attribution Report (CLM-0700-Q). This report lists new attributions, continuing
attributions and terminated attributions. Modifications have been made to the
attribution process to include the Termination Reason Code to both the PDF and
CSV versions of the report. These codes indicate the reason an attribution was
terminated for a provider.
In
addition, new columns were added to the CSV version of the report to include
Provider NPI, Provider MCD, and Provider Name at the beginning of each
row.
The
termination reason code and descriptions are noted in the following table:
|
Termination Reason
Code
|
Description
|
|
1
|
RECIPIENT HAS BEEN ATTRIBUTED
TO A NEW PROVIDER
|
|
2
|
RECIPIENT NO LONGER ASSIGNED TO
AN ACHN NETWORK
|
|
3
|
RECIPIENT NOT MET MONTHS OF
ELIGIBILITY REQUIRED
|
|
4
|
RECIPIENT HAD NO CLAIMS IN THE
EVALUATION PERIOD
|
|
5
|
RECIPIENT HAS BEEN REKEYED.
THIS ID IS NO LONGER ACTIVE
|
The addition of the termination reason codes (TERM) will
be included in the May 2020 run of the attribution process. Reports will be
available to providers during the first week of June 2020.
A sample of the revised PDF and CSV report layouts are provided on the following
page.
If you have questions, please visit the Medicaid website at www.medicaid.alabama.gov, or call the Medicaid Fiscal Agent at
1-800-688-7989.
You may also contact the Medicaid Agency's Network Provider Assistance Unit at 334-353-5907 or 334-353-4257.
CLM-0700 -- Quarterly Attribution Report (PDF) displays the New 'Term' Field and Termination Reason Codes.
The following CSV version of the report shows the 'Provider NPI, Provider MCD, and Provider Name, and Term Reason' columns are present on each row.
Note: CSV example has been split for easier viewing.
New column for 'TERM Reason' is present on the report:
The Current Procedural Terminology (CPT) and
Current Dental Terminology (CDT)
codes descriptors, and other data
are copyright © 2020
American Medical Association and © 2020 American Dental Association (or such other date publication of CPT
and CDT). All rights
reserved. Applicable FARS/DFARS apply.