Medicare Compliance & Reimbursement

The Centers for Medicare Medicaid Services has sent statements of intent the way of the dinosaur after concluding that the procedure, which was originally set up to allow beneficiaries more time to file claims, is apparently of little use to its intended targets.
 
According to a final rule in the April 23 Federal Register, 98 percent of claims currently filed are done on assignment, as opposed to 52 percent almost 30 years ago. Additionally, of the vast number of SOI claim requests submitted, only 4.4 percent are actually processed and paid.

"We have concluded that the SOI process is a resource burden on Medicare contractors, providers and suppliers with little return or benefit to the states," the rule reads.

CMS says it hopes the change will encourage states to pursue cost-avoidance procedures and reduce processing expenses -- while having little financial impact on providers and suppliers since the 15 to 27 month claim submission period remains unchanged.

To view the rule, go to http://www.access.gpo.gov/su_docs/fedreg/a040423c.html. 

Lesson Learned: The elimination of the little-used SOIs is predicted to have a mostly positive effect on suppliers and contractors.