Return to Provider (RTP)
When a claim is submitted it processes through a series of edits in the Fiscal Intermediary Standard System (FISS), to ensure the information submitted is complete and correct. If the claim has incomplete, incorrect or missing information, it will be sent to your return to provider (RTP) file. For example, if an invalid HCPCS code is submitted, the claim will be moved to the RTP file in status/location T B9997 for the provider to correct.
Providers can access claims in the RTP file by using FISS, and to make the necessary corrections to the claim. The claim will remain in the RTP status/location T B9997 for up to thirty-six months. For assistance on how to access claims in RTP, and for detailed instructions about correcting claims in the RTP file, refer to the Claims Corrections section of the FISS Reference Guide.
A new receipt date is assigned to a claim when it is moved out of the RTP.
Refer to the Top Claim Submission Errors and How to Resolve Web page to review the top reason codes that cause billing transactions to either reject or move to your Return to Provider (RTP) file for correction.
Page last updated: April 28, 2008
