Tuesday, April 2, 2013

Centers for Medicare & Medicaid Services (CMS) Quarterly System Release – Claim Hold

The Centers for Medicare & Medicaid Services (CMS) has identified technical issues with certain parts of the April 2013 quarterly systems release. For claims with dates of service or “Through Dates” on or after April 1, 2013, the issues affect (1) all Home Health final claims, (2) outpatient Critical Access Hospital (CAH) and Rural Health Clinic (RHC) claims where dollars have been applied to the beneficiary deductible, and (3) the remittance advice summary payment amount forMedicare Advantage inpatient prospective payment system (IPPS) claims with indirect medical education (IME). Actual payments and the claim-level payment amounts on the remittance advice are correct for these Medicare Advantage IPPS IME claims. Final home health, outpatient CAH and RHC, and Medicare Advantage IPPS IME claims with dates of service or “Through Dates” prior to April 1, 2013, are unaffected. To read more click here.