Medicare Timely Filing Reduced to 12 Months


As you may recall in my earlier health reform blog,  I noted that one of the several changes to be implemented was the reduction of the initial claims filing period reduced from 18 months to 12 months.  I would encourage you to read the other operational changes impacting collections noted in the blog.

Region A MAC and HCCA Compliance Weekly published the system change on May 14.  Each contractor may have a different published date but it appears that the announcements will be coming very shortly.

Note the change is RETROACTIVE to all claims on or after January 1, 2010! This would indicate that CMS has most likely directed all contractors to this announcement.  Notify your billing staff ASAP, they only have 1 year to file an initial claim.  For providers who must receive documentation from physician’s prior to billing, you must be more diligent than ever before.  If the physician’s are not providing the necessary information to bill for the services ordered, get the patient involved.  The patient can request a copy of their record at any time and can carry the order to the physician for signature.

Angela Miller of Medical Auditing Solutions LLC has been in health care compliance, auditing, billing, collections and HIPAA for over 18 years.  Ms. Miller has made it the  focus of the business to help providers run their businesses efficiently, collect money, and maintain compliance with federal and state regulations and coverage criteria.  Ms. Miller is very experienced with Medicare & Payer audits.  Ms. Miller ran a very successful compliance program for over 5 years for the largest private held HME/Pharmacy provider in the US at the time.  Ms. Miller  also works as a contract compliance officer to provide an avenue to compliance training to staff, implementation of policies, as well as handling anything that affects cash flow from the initial intake to back-end collections. You can visit our website at Medical Auditing Solutions LLC.

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