Pre-claim Reviews – Breaking News

August 5, 2016

Greetings everyone. We’re all busy so let’s keep this one brief. There are a few new items that have come up for pre-claim review that looked important enough to share immediately so here they are.

There is an updated start date for the pre-claim review demonstration in Illinois. That date is August 3, 2016. The revised start date will not affect the three-month grace period – which still ends October 31, 2016. This means any payable claims submitted from Illinois on or after November 1, 2016 that do not have a pre-claim review affirmed decision will have the 25% penalty applied to the claim. It also should not impact the end date of the demonstration. For more information on this modified end date, please see here.

Also, there is now a pre-claim review eServices decision tree job aid. Palmetto did a great job of laying out all of the information that will be required in the online portal. To access this job aid, please go here.

And finally, Palmetto has developed an online pre-claim review status tool to find out the status of your pre-claim review requests. You can find this tool here.

As always, Palmetto’s pre-claim review website has a lot of helpful information. You can find it here.

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