History Only Adjustments and Voids

Tuesday, February 4, 2020

This communication serves as an advisory notice for all providers. The intent is to increase awareness of history-only adjustments and voids within NCTracks. 

History-only processing occurs to record the recovery of monies on a previously paid claim received from any source. The posting could originate from a provider refund using the fiscal agent lockbox or it could originate from the posting of recovery from a commercial insurer by the state’s third-party liability vendor. 

History-only processing describes the scenario where the state has received funds that need to be applied to a historical paid claim without any further reprocessing. Medicaid does not touch the payment previously made to providers; therefore, the history-only claim activity is not shown on the provider remittance statement. History-only adjustments and voids do not impact a provider’s reimbursement. There is no movement of a provider’s funds. 

Providers who want to see the NCTracks remittance statement reflect the return of provider funds on a previously paid claim must utilize a claim adjustment or claim void, instead of issuing a refund to the fiscal agent lockbox. Adjusting or voiding the claim will show the posting activity and allow the provider to control the timing of the adjustment/void process. Instances where the third-party liability vendor records the recovery of money received on a previously paid claim the claim activity will not show on the provider remittance statement. 

Author: 
NC Medicaid Third-Party Recovery, 919-527-7690