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Tags Posts tagged with "Mass Claims Adjustment"

Mass Claims Adjustment

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The Office of Child Development & Early Learning (OCDEL) notified all County Early Intervention (EI) Programs and Providers that they will perform one final Mass Claims Adjustment on April 21, 2026.

As a result of the final analysis of the denied claims file, they were able to identify that many of the denied claims can be processed again and should result in a Paid claim. This final Mass Claims Adjustment will significantly reduce the manual efforts for both the County and EI Provider.

Immediately following this final Mass Claims Adjustment, a revised and final report of denied claims will be issued to all County EI programs to distribute to their contracted providers. 

Reminder of Next Steps:

  • Using the newly published Fiscal Year 2025/26 Fee Schedule — File NEW claims on or after March 9, 2026, that contain a date of service on or after July 1, 2025.
  • Using the newly published Fiscal Year 2025/26 Fee Schedule — Adjust claims filed on or after March 9, 2026, that contain a date of service on or after July 1, 2025, if the OLD fee schedule was used.

The Bureau thanks all stakeholders for their patience as they work to streamline the process and expedite the payments for provided Early Intervention services.

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The Office of Child Development & Early Learning (OCDEL) has completed the Mass Claims Adjustment for all PAID CLAIMS of Early Intervention (EI) services that contain a date of service between July 1, 2025 – March 8, 2026 and were filed on or before March 8, 2026.

Due the high volume of claims, the Mass Claims Adjustment was processed in daily batches with a summary of claims below:

  • Week 1: March 16, 2026
    • Claims Adjusted for Speech Therapy
    • Claims Adjusted for Occupational Therapy
    • Claims Adjusted for Physical Therapy
  • Week 2: March 23, 2026
    • Claims Adjusted for Special Instruction
    • Claims Adjusted for Audiology/Evaluation/Teaming
    • Claims Adjusted for Service Coordination

A complete review of the Mass Claims Adjustment was performed during the week of March 30, and a final batch of claims were processed on April 7, representing claims with a date of services of July 1, 2025.

Reminder of Next Steps:

  • Using the newly published Fiscal Year 2025/26 Fee Schedule, file NEW claims on or after March 9, 2026, that contain a date of service on or after July 1, 2025.
  • Using the newly published Fiscal Year 2025/26 Fee Schedule, adjust claims filed on or after March 9, 2026, that contain a date of service on or after July 1, 2025, if the OLD fee schedule was used.

IMPORATANT:

As expected, OCDEL reports that there are many ICNs that failed the Mass Claims Adjustment. The Bureau is preparing a document for each County to distribute to their contracted providers that includes the original ICN that did not successfully Mass Adjust. Detailed instructions will be included with this document for how the Infant Toddler program and EI Provider can work together to resolve the claims errors. After successful resolution of the claims error, providers will be responsible for performing their own Claims Adjustment for the claims that failed the Mass Claims Adjustment.

View the following links for more information:

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