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Attention Providers: Modified Claims Processing and Payment Schedule


Wednesday, July 25, 2012

The new Medicaid Management Information System (MMIS) will be implemented on December 21, 2009.

As a result of the implementation, checks will not be issued the week of January 1, 2010. Regularly scheduled check disbursements will resume on January 8, 2010.

Additionally, the claims adjudication cycle will be temporarily modified.  Please note the following important claims submission dates.

  • Paper adjustments and voids received by November 13 will be processed by November 20.
  • Paper adjustments and voids received after November 13 will be held until processing begins in the new system on December 21.
  • Electronic adjustments and voids received by November 19 will be processed in the November 20 cycle.
  • Electronic adjustments and voids received after November 19 will be rejected by the EDI Gateway.  These electronic adjustments and voids may be submitted on or after December 21.
  • Paper claims received on or before December 11 will be processed by December 18.
  • Paper claims received after December 11 will be held for one week until the new system has been implemented. These claims will be processed beginning the week of December 21.
  • Electronic claims received by noon on December 17 will be processed by December 18.
  • Electronic claims received after noon on December 17 will be held and submitted for processing beginning the week of December 21.
  • The new system will be implemented on December 21 and the first payment cycle will run on January 1, 2010.

If you have any questions, please contact Provider Inquiry at (202) 906-8319 (inside DC metro area) or (866) 752-9233 (outside DC metro area).