Medicare’s New Well timed Submitting Guidelines

Medicare has all the time had essentially the most relaxed guidelines concerning well timed submitting. Beneath the outdated guidelines Medicare claims might be submitted for the final quarter of the yr previous to the earlier yr – which implies that claims for dates of service 10/1/08 or after will be submitted as much as December 31st of 2010. There was a 10% penalty for any claims older than one yr, however they might nonetheless be paid on. That has come to an finish.Beneath the brand new edits, claims will solely be processed for cost for as much as a calendar yr. So for date of service June 22, 2010 the declare have to be submitted previous to June 22, 2011.The implementation of the brand new edits shall be as follows: All claims with service dates previous to 1/1/2010 have to be submitted previous to 12/31/2010 and shall be processed in response to the outdated pointers. All dates of service 1/1/2010 and after shall be topic to the brand new pointers and can solely be allowed inside one calendar yr.

This new ruling impacts all Medicare supplier varieties. It impacts all physicians, suppliers and suppliers that submit claims to Medicare contractors together with sturdy medical gear suppliers, house well being, Medicare Elements A & B. Principally anybody who supplies companies to Medicare beneficiaries and submits claims for these companies.It’s important that anybody who does billing for Medicare suppliers understands the brand new edits. A lot cash will be misplaced. Do not wait until the final minute. Start clearing up any Medicare claims for dates of service previous to January 1st of 2010 now.Should you observe some key pointers you shouldn’t have any issues even beneath the brand new edits. Claims needs to be submitted as near the date of service as potential. If submitting electronically, digital experiences needs to be learn and acted upon. Whether or not submitting on paper or electronically, observe up or getting old experiences needs to be run frequently and labored on. Any claims over 20 days if submitting electronically and 45 days if submitting on paper needs to be checked on. Any denials acquired by Medicare needs to be acted upon shortly. If there’s something that may be corrected, repair it and rebill shortly. If it’s a affected person problem, invoice the affected person in order that they will deal with something from their finish that must be finished. This permits time to resubmit if needed.

Actually, the outdated guidelines have been good for us as a billing service. If we went into an workplace that was having billing points we might often recuperate most of their Medicare cash. However with present accounts the well timed submitting edits did not impact us. Our coverage is to not let claims get that outdated. However for workplaces that should not have good billing practices, the brand new edits could also be powerful.Copyright 2010 – Michele Redmond – Options Medical Billing Inc

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