Timely Claims Filing Requirement

Important Information on the Timely Claims Filing Requirement

CMS reminds Medicare Fee-for-Service (FFS) physicians, providers and suppliers submitting claims to Medicare for payment that, as a result of the Patient Protection and Affordable Care Act (PPACA), all claims for services furnished on or after January 1, 2010, must be filed with respective Medicare contractor no later than one calendar year (12 months) from the date of service or Medicare will deny those claims.

Medicare contractors are adjusting (as necessary) their relevant system edits to ensure that:

1. Claims with dates of service prior to October 1, 2009 will be subject to pre-PPACA timely filing rules and associated edits;

2. Claims with dates of service October 1, 2009 through December 31, 2009 received after December 31, 2010 will be denied as being past the timely filing deadline and;

3. Claims with dates of service January 1, 2010 and later received more than 1 calendar year beyond the date of service will be denied as being past the timely filing deadline.

Reference: http://www.cms.gov/MLNMattersArticles/downloads/MM6960.pdf

Additional information: http://www.cms.gov/MLNMattersArticles/downloads/MM7080.pdf

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