If a patient is involved in another demonstration, such as an Accountable Care Organization, should the UTN be removed?
Published 01/23/2023
Answer: Beneficiaries involved in a Demonstration Program, such as an Accountable Care Organization (ACO), are excluded from the Review Choice Demonstration (RCD). Beneficiaries cannot be in two demonstration programs at the same time. If the home health agency (HHA) and beneficiary are both part of the ACO and the HHA submits a Unique Tracking Number (UTN) on a claim for a beneficiary in an ACO, the claim will be returned with reason code 39621. The HHA should remove the UTN from the claim and resubmit because they should not be included on claims in any of the following scenarios:
- Requests for Anticipated Payment (RAPs)
- Providers and beneficiaries currently involved in another Demonstration Program