Important Information on the Timely Claims Filing Requirement

The Centers for Medicare & Medicaid Services (CMS) would like to remind 
Medicare Fee-For-Service physicians, providers and suppliers submitting claims 
to Medicare for payment, as a result of the Patient Protection and Affordable 
Care Act (PPACA), effective immediately, all claims for services furnished on 
or after Jan 1, 2010, must be filed with your Medicare contractor no later than 
one calendar year (12 months) from the date of service - or Medicare will deny 
them.


In general, the start date for determining the 1-year timely filing period is 
the date of service or "From" date on the claim.  For institutional claims that 
include span dates of service (i.e., a "From" and "Through" date on the claim), 
the "Through" date on the claim is used for determining the date of service for 
claims filing timeliness.  For claims submitted by physicians and other 
suppliers that include span dates of service, the line item "From" date is used 
for determining the date of service for claims filing timeliness.



For additional information about the new maximum period for claims submission 
filing dates, contact your Medicare contractor, or review the MLN Matters 
articles listed below related to this subject:



§  MM6960 - "Systems Changes Necessary to Implement the Patient Protection and 
Affordable Care Act (PPACA) Section 6404 - Maximum Period for Submission of 
Medicare Claims Reduced to Not More Than 12 Months" - 
http://www.cms.gov/MLNMattersArticles/downloads/MM6960.pdf on the CMS website.

§  MM7080 - "Timely Claims Filing: Additional Instructions" - 
http://www.cms.gov/MLNMattersArticles/downloads/MM7080.pdf on the CMS website.



You can also listen to a podcast on this subject by visiting 
http://www.cms.gov/CMSFeeds/02_listofpodcasts.asp on the CMS website.



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January Flu Shot Reminder
Get Your Flu Vaccine - Not the Flu. Don't forget to immunize yourself and your 
staff. Protect your patients. Protect your family. Protect yourself. While 
seasonal flu outbreaks can happen as early as October, flu activity usually 
peaks in January. This year's vaccine will protect against three different flu 
viruses, including the H1N1 virus that caused so much illness last flu season. 
The risks for complications, hospitalizations and deaths from the flu are 
higher among individuals aged 65 years and older. Medicare pays for the 
seasonal flu vaccine and its administration for seniors and others with 
Medicare with no co-pay or deductible. Health care workers, who may spread the 
flu to high risk patients, should get vaccinated too. Remember - Influenza 
vaccine plus its administration are covered Part B benefits. Note that 
influenza vaccine is NOT a Part D covered drug. For information about 
Medicare's coverage of the influenza vaccine and its administration, as well as 
related educational resources for health care staff, please visit 
http://www.cms.gov/MLNProducts/Downloads/Flu_Products.pdf and 
http://www.cms.gov/AdultImmunizations on the CMS website.





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