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For ProvidersNews & UpdatesAddress Change for Submitting Refunds to RightCare


Address Change for Submitting Refunds to RightCare

Submitted by admin on Thu, 08/30/2012 - 17:17

Date: August 30, 2012

Effective Date: September 1, 2012

Effective September 1, 2012, the address for submitting refunds to RightCare from Scott and White has changed. The new address is as follows:

RightCare from Scott and White Health Plan
PO Box 841476
Dallas, TX 75284-1476

Providers are prohibited from receiving payment from RightCare from Scott and White, billing a third-party resource (TPR), and then refunding the lesser of the two payments to RightCare. RightCare is responsible for processing financial adjustments when any of the following occur: overpayment, duplicate payment, payment to incorrect providers, and overlapping payments by RightCare and a TPR.

Refunds owed to RightCare must not be held until the end of an accounting year. Providers that identify a TPR within 12 months of the date of service and wish to submit a claim for payment to a third-party health insurer after a claim for payment has been paid by RightCare must refund any amounts paid by RightCare before submitting a claim for payment to the third party.

In accordance with Title 1 Texas Administrative Code (TAC) §§354.2321 [g] and 354.2322 [i], providers that do not follow TPR rules "may be referred for investigation and prosecution for violations of state and/or federal Medicaid or false claims laws." Providers should refer to the full text of these rules for a full description of payment requirements.