Long-Term Care

Reminder: Be aware of timely filing requirement changes

MDS 3.0 Insider, December 27, 2010

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As the end of the year approaches, it is important that Medicare Fee-For-Service (FFS) physicians, providers, or suppliers submitting claims to Medicare for payment remember the newly implemented timely filing requirement. CMS updated edit criteria related to the timely filing limit for submitting claims for Medicare FFS reimbursement. 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.

It is important that agencies look at their claims and understand when to file in accordance with these new deadlines:

  • Claims with dates of service prior to October 1, 2009 will keep their original December 31, 2010 deadline for filing
  • Claims with dates of service October 1, 2009 through December 31, 2009 received after December 31, 2010 will be denied
  • Claims with dates of service January 1, 2010 and later received more than one calendar year beyond the date of service will be denied

Two MLN Matters articles explain the timely filing requirement in-depth and further explain claims for services that require reporting of a line item date of service. Read the two MLN Matters articles that explain the timely filing changes at: http://www.cms.gov/MLNMattersArticles/downloads/MM6960.pdf and http://www.cms.gov/MLNMattersArticles/downloads/MM7080.pdf.

CMS also has a podcast dedicated to the subject, which can be found at http://www.cms.gov/CMSFeeds/02_listofpodcasts.asp
 



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