Reimbursement:
Timely Filing Problem Solved With System Bypass
Published on Tue Mar 15, 2011
HHAs with incorrectly rejected claims must turn to contractor. Medicare's new 12-month timely filing rule for claims was getting even tighter for home health agencies, but now the feds have cleared that up. Problem: Under the new 12-month rule, the Medicare claims system uses the date in the "through" field on an HHA claim to determine the filing deadline. But because requests for anticipated payment (RAPs) have to have the same "from" and "through" dates, RAPs were getting rejected as untimely, preventing timely final claims from being able to process. (For more details, see Eli's HCW, Vol. XX, No. 11, p. 87.) Solution: The Centers for Medicare & Medicaid Services "has instructed Medicare contractors to bypass the enforcement of timely filing on RAPs," CMS says in an e-mail message to providers. If this problem has already affected your claims, you'll have to get in touch with your contractor for relief. [...]