Current Coding Tip
Important Notice:
Most Medicare Providers Will Be Required to Revalidate Medicare Enrollment Prior to March 23, 2013
Medicare has launched a huge effort to revalidate nearly all Medicare providers during the next eighteen months. This revalidation relates to Medicare Part B and is separate from the DMEPOS re-enrollment that is already underway.
Fraud continues to be a significant threat to the financial health of the Medicare program. To reduce the level of fraud, the Centers for Medicare and Medicaid Services (CMS) will be scrutinizing each provider through the revalidation process.
Only providers who have enrolled in Medicare since March 25, 2011 will be exempt from revalidation, as they have already been exposed to the new system. All other providers will be notified individually, sometime between now and March 23, 2013, and will be required to be revalidated as providers. For now, simply watch your mailbox for the revalidation information from CMS. You do not need to take any action until then.
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Important Information on the Medicare Requirement for Timely Claims Filing
All 2009 Claims Must Be Filed by December 31, 2010! One Year Limit!
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. If you have Medicare Fee-For-Service claims with service dates from January 1, 2009, through Dec 31, 2009, those claims MUST be filed by Dec 31, 2010, 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.
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AOA’s staff and volunteers handle thousands of questions from members each month, with many of the questions related to medical records, coding, insurance contracts, Medicare and other third party issues. In an effort to educate members on increasing billing efficiency, AOA is launching a Billing & Coding Webinar Series.
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