Chiropractor Recovery Letters and Corrected Claim Submission Process

Date: 06/07/23

In April 2023, Iowa Total Care re-sent the Chiropractic Recovery Project letters for 2021 and 2022 claims that were billed incorrectly per Iowa Medicaid guidelines (see Resources below). Iowa Total Care is aware that providers are correcting their claims to align with this guidance and are noticing payments on their updated corrected claims.

Iowa Total Care is extending the timeframe for these claim corrections until August 1, 2023, due to the high volume of claims and extended processing time needed for corrections.

When the recoupment process begins, providers making claims corrections may continue to do so. The corrected claims will continue to pay, and the timely filing for those claims will continue to be waived.

Iowa Total Care’s Process for Handling Corrected Claims

• The original claim will receive an explanation code of 0B on the remittance advice.
• The corrected claim will pay out monies.
• The two claims should offset each other.
• While Iowa Total Care strives to send both claims on the same Explanation of Payment (EOP), there are situations where the 0B and the payment could go out on different checks/EOPs.
  • Both claims will be processed.
  • If they do not go out together, you will see the offset of these claims on a future EOP.

Resources

Iowa Medicaid guidelines are available under Chiropractic Diagnosis Codes by Category on the Iowa Department of Health and Human Services Covered Services, Rates, and Payments page.

For questions or concerns, contact your Provider Relations Specialist or call Provider Services at 1-833-404-1061.

Thank you for your partnership in serving Iowa Total Care members.