Dermatology Coding Alert

You're already bracing for the nine days without Medicare payments in late September--but the situation may actually be worse than you're expecting.

The problem: Medicare plans to hold all claims from Sept. 22 through Sept. 30, as required by the Medicare Modernization Act. (See the article "Here's How to Prepare for 9 Lean Medicare Days" in the July 2006 issue of Medical Office Billing & Collections Alert for more tips on handling the payment slowdown.)

CMS had claimed that all of those claims would be paid promptly on Oct. 2. But it turns out that may not be strictly true.

Some large carriers "may have a little difficulty mailing all of these held payments on a single day," a CMS official told the Aug. 11 physician open-door forum. "Be patient with them," he pleaded. The carriers' mailrooms may have difficulty sending out that many checks on a single day.

"It might take up to about three days before those checks can get out, but they will all be dated Oct. 2 and ready to go," the CMS official added.

So it's even more important than ever before to prepare for what may turn into 12 lean days.

Experts offer the following tips:

• Don't get left behind. Make sure you're caught up on all of your Medicare billing before the hold on payments begins at the end of September. Any claims that you submit close to the deadline that don't get processed before Sept. 21 won't be processed or paid until at least Oct. 1. Having as many claims as possible processed before the deadline will ensure your office's cash flow isn't as hard-hit.

• Keep billing during the slowdown. Although the Medicare payment system is on hold during this period, your billing system shouldn't be, says consultant Melinda Gaboury with Healthcare Provider Solutions in Nashville, Tenn. "Do not discontinue billing for any time period," she says.

• Be efficient. Don't waste time during the payment hold period calling your Medicare carriers about claims. Concentrate on your other payers during that time.