Saturday, August 14, 2010

IMPORTANT!!!! Changes to the Medicare Timely Filing Limits!

"Timely Claims Filing: Additional Instructions"

In January 2010 Medicare changed their rules regarding timely filing of claims, and again has updated and clarified those rules. Below is a link to that Med-learn matters article. I've also listed the highlights of the article.

Key Points

Claims with dates of service on or after January 1, 2010, received later than one calendar year beyond the date of service will be denied by Medicare.

 …New changes …

 Institutional claims that include span dates of service (i.e., a “From” and “Through” date span on the claim), the “Through” date on the claim will be used to determine the date of service for claims filing timeliness.

 Professional claims (CMS-1500 Form and 837P) submitted by physicians and other suppliers that include span dates of service, the line item “From” date will be used to determine the date of service and filing timeliness. (This includes supplies and rental items).

 BE AWARE: If a line item “From” date is not timely, but the “To” date is timely, Medicare contractors will split the line item and deny untimely services as not timely filed.

 Claims having a date of service of February 29th must be filed by February 28th of the following year to be considered as timely filed. If the date of service is February 29th of any year and is received on or after March 1st of the following year, the claim

• Be sure your billing staff is aware of these changes!!!!

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