RETROACTIVE PROCESSING SOPS
Retroactive Adjustment Requests: All Retroactive Adjustment Requests must comply with CMS Guidelines and Regulations, which include Chapter 2, 7, 17d, 19, and the Prescription Drug Plan (PDP) Guidance. However, plans must also follow CMS’ Standard Operating Procedures (SOPs) when submitting retroactive requests to us. For your convenience all applicable SOPs are provided below and should be used as a step-by-step guide when preparing and submitting retroactive adjustments. Below you will find several SOPs, specific to the type of retroactive request you are submitting. Simply click on any of the links below to download our SOPs.
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