The Retroactive Processing (RPC) Toolkit is designed to provide organizations or plans with valuable resources and tools to properly submit retroactive requests to us.
The RPC Toolkit contains all the necessary information and tools needed to submit retroactive requests. Please click on the links below to obtain the required forms and instructions to submit requests in accordance with CMS Guidelines.
RPC Submission Spreadsheet
RPC Enrollment Documentation Worksheet
RPC LIS Documentation Worksheet
RPC Payment Validation Documentation Worksheet
RPC Documentation Requirements Matrix
RPC Transaction Inquiry Template
Definition of Codes on Final Disposition Reports