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Medicare Compliance & Reimbursement

Physician Notes:

At Least 1 MAC Processed Part B Claims Using 21 Percent 'Pricing Error'

Published on Sun Apr 25, 2010

21 percent pay cut averted but several claims still slip through the system. President Obama has helped you avert a 21 percent pay cut by signing the "Continuing Extension Act of 2010" -- but one MAC let several claims slip through the system using the discounted payment formula, and the payer is in the process of correcting its error. Just before the president signed the law on April 15, MACs had been holding all claims for dates of service between April 1 and April 14. Even though the pay freeze was retroactive to April 1, some practices worried that their MACs might process claims using the 21 percent reduced fee during the period on April 15 after the claims hold expired but before the president signed the law. In one case, those fears may have been warranted. According to an April 26 notification from Highmark Medicare Services (a Part B payer [...]
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