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Created by Guest
Created on Apr 28, 2021

Add patient age criteria to a claim rule

I want to add criteria about a patient's age to a claim rule.
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  • Guest
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    Aug 12, 2021
    NC Medicaid has carved out children who are less than 3 years old from the Medicaid managed care plans and in order for Medicaid to know which of these children have been carved out providers are to use modifier TL on our claims. I have to manually look at each claim and sight the DOB to know if a modifier needs to go on the claim before it is invoiced to Medicaid. Thank you for considering this request.