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PCCM Case Management Fee Issue Identified
Information Posted June 2, 2006: TMHP has identified an issue that may impact Primary Care Case Management (PCCM) primary care providers’ monthly case management fee payments (per member, per month fee) for the month of May 2006. Some PCCM checks issued for May 2006 did not reflect the appropriate amount in relation to the actual number of clients assigned to the primary care provider on the May 2006 Panel Report Roster.

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Reconciliation will be completed and reflected by August 2006. This may result in an additional payment on providers’ August 2006 case management checks (if a client was added to a primary care providers panel for the month of May 2006), or a recoupment (if a provider terminated a client; or a client changed primary care providers). If a recoupment is initiated, it will be reflected as an accounts receivable on the August 2006 Remittance and Status (R&S) report. No action on the part of the provider is necessary.

 

For additional information, call the TMHP Contact Center at 1-800-925-9126.

 

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