Home Health & Hospice Week
Medicare Claims Processing System Glitches Cleared Up In The New Year
But beware of one home health agency overpayment snafu that continues.
A number of claims processing errors should plague you no more, now that the latest Medicare claims system release is in.
For example: The system was having problems matching RAPs to their final claims when a duplicate RAP was submitted, HHH Medicare Administrative Contractor CGS says on its FISS Claims Processing Issues webpage. But now a solution was implemented with the January 2014 release, CGS confirms.
Other problems addressed by the release were that final claims were processing with no RAPs; demand denial claims were inappropriately rejecting as duplicates against the RAP; and RAPs were inappropriately rejecting or suspending with MSP codes, CGS adds.
Unresolved: Overpayment amounts showing in the ‘adjustment to balance’ field on the standard paper remittance advice or as adjustment reason code 90 on the electronic remittance advice (ERA) is an ongoing problem, CGS indicates. "Providers should track the dollar amount associated with the overpayment and the RA/ERA paid date, as future recoupment is anticipated," the MAC says on its site. "CGS does not recommend reporting this overpayment on a credit balance report."
Home Health & Hospice Week
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Medicare Claims Processing System Glitches Cleared Up In The New Year
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