RESOLVED: Home Health RCD and Outpatient Department Prior Authorization Unique Tracking Numbers

Published 03/28/2025

RESOLVED: Home Health Review Choice Demonstration (HH RCD) and Outpatient Department Prior Authorization (PA) Unique Tracking Numbers (UTNs)
Current Status Date  
Resolved March 25, 2025 Status: All impacted UTNs have been pushed through the common working file and have finalized as normal.
Provider Action: Impacted providers can return to their normal billing procedures.
Open February 11, 2025 Status: This issue is in research.
Provider Action: Once providers receive the UTN with a decision, please wait 2 business days before sending the claim. If providers receive reason code C5461 or C5463, please wait two business days before resending the claim for processing.
Issue Description
The S.C. Region of Fiscal Intermediary Shared System (FISS) is experiencing delays in creating and updating home health RCD and Outpatient Department PA UTNs. The pending UTN will cause the claim to RTP with reason code C5461 or C5463. This issue mainly affects UTNs receiving a decision from January 23–24, 2025. 

 


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