08/06/2021

WPS will begin processing HHA Request for Anticipated Payment (RAP) claims, bill type 322, with a work-around for the 2021 RAP NO-PAY processing guidelines.

The RAP claims will be processed with a temporary Denial Reason Code of 020. This charge is considered included in A Paid Service, until the final system update is completed and the actual DRC is moved into production along with the 2021 HHA pricer release.

When the Explanation of Benefit (EOB) is received with the 020 DRC, please disregard the statement that indicates to follow the steps to submit an allowable charge review for the RAP claim denial.

If there are any questions, please reach out to your local TRICARE Community Liaison (TCL) or a customer service representative for additional assistance.