ResDAC is currently experiencing a high volume of requests, which may delay response and processing times. We are working to address the backlog as quickly as possible and appreciate your patience.
ResDAC is currently experiencing a high volume of requests, which may delay response and processing times. We are working to address the backlog as quickly as possible and appreciate your patience.
Fixed payments are made by the state to insurers or providers for premiums or eligible coverage, not for a particular service. For example, some states have Primary Care Case Management (PCCM) programs where the state pays providers a monthly patient management fee of $3.50 for each eligible participant under their care. This fee is considered a fixed payment.
It is very important for states to correctly identify fixed payments. Fixed payments do not have a defined “medical record” associated with the payment; therefore, fixed payments are not subject to medical record request and medical record review.
SOURCE: T-MSIS Analytic File (TAF) Claims