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Just
curious if there has been any further definition of the "exceptions" mentioned
in the CMS FAQ below:
effective October 16, 2003, Medicare is
prohibited by law from paying paper claims except for those from small providers
and under certain other limited circumstances. After that date, any
provider that does not meet the “small provider” or other exception would
have to return to electronic claims submission in order to continue to receive
Medicare reimbursement.
I am
unable to find an update.
Please
let me know.
Thank
you.
Michelle
Tiffany,
I'm not sure about CMS, but Congress didn't allow for any
exceptions unless explicitly approved by the Secretary. So far, no
exceptions have been forthcoming.
The opinions expressed here are my own and not necessarily the opinion of
LCMH.
Douglas M. Webb Computer System Engineer Little Company of Mary
Hospital & Health Care Centers [EMAIL PROTECTED]
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----- Original Message -----
Sent: Monday, April 21, 2003 01:41
PM
Subject: RE: Paper Claims to
Medicare?
Kathy -
Do
you know if CMS is going to require all secondary claims electronically by
this date as well?
Tiffany
Tiffany
Gutraj Rosik
http://www.amicore.com
200 Minuteman Rd
Andover, MA. 01810
Hi
Michael,
I
have pursued this issue with CMS, and their response has been that all
claims must be submitted electronically as of 10/16/03, no
exceptions.
The
837 transaction supports indicating on the claim that paper documentation
will follow the claim. See
the PWK segment in the 2300 loop.
Your system would need to provide a report of claims that need
documentation, so you can submit the documentation to be matched by
Medicare to the claim.
Thank
you,
Kathy Carlin,
Principal Consultant
Siemens Medical
Solutions
UCLA Phone
310-301-5219
UCLA email: [EMAIL PROTECTED]
Siemens Voicemail
610-219-2067
Siemens email:
[EMAIL PROTECTED]
-----Original
Message-----
From: Costa,
Michael [mailto:[EMAIL PROTECTED]
Sent: Thursday, April 17, 2003 11:47
AM
To: WEDI SNIP
Transactions Workgroup List
Subject: Paper Claims to
Medicare?
I work for an
organization that manages multiple physician practices. Several
practices that submit electronic claims to Medicare currently submit
claims in excess of $10K via paper. Their justification for this is
that Medicare automatically rejects claims that are equal to or greater
than $10K, requesting supporting documentation before they'll even look at
them. So, rather than go through the rejection process, the
practices just drop these claims to paper and send them along to Medicare
with the supporting paper documentation. Although these practices
are preparing to submit their electronic claims via the 837P format, their
preference would be to continue with the status quo to limit the extra
steps.
Does anyone know
if HIPAA/ the ASCA permits providers to submit high cost claims to
Medicare via paper? If this isn't permissible under HIPAA, than can
anyone speak to how they're handling this issue?
Thanks
all
Mike Costa,
RHIA
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