Alabama

Effective December 28, 2021, the Alabama Medicaid Agency will replace Claim Adjustment Reason Code (CARC) 45 with a new code to ensure compliance with the Committee on Operating Rules for Information Exchange (CAQH CORE) combinations reported on the X12 835 Electronic Remittance Advice (RA). The new CARC is as follows: 

CARC (96) – (non-covered charge(s)) with an appropriate Recipient Advice Remark Code (RARC) for the situation. 

UPDATE: These changes are currently available in our test environment for Provider and Vendor testing. Testing should be completed by December 24, 2021. The updated reporting will be implemented for claims appearing on the January 7, 2022 check write going forward.  

Also in Alabama, effective December 28, 2021, Alabama Medicaid will implement changes to the 271 Eligibility and Benefit Response transaction to ensure compliance with the Committee on Operating Rules for Information Exchange (CAQH CORE) for “Normalizing” the last name, which means removing all special characters, punctuation, upper case letters, suffixes, and prefixes to increase the chances of a match.  

UPDATE: These changes are currently available in our test environment for Provider and Vendor testing. Testing should be completed by December 24, 2021.  

Providers with questions concerning the upcoming change can submit them via the following email address: interChange_testing@DXC.com. 

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.