CMS Identifies Supplemental Payer Crossover Error
The Centers for Medicare & Medicaid Services (CMS) recently identified a problem that requires immediate action on the part of Medicare Part B providers. Apparently, claims were not automatically crossing over to supplemental payers even though provider remittance advice indicated otherwise.
Providers should review their remittance advice with an issue date between Jan. 5 and Feb. 12. Look for remittance advice that has two or more service lines for a beneficiary where both of the following criteria apply:
- One service line is 100 percent reimbursable (i.e., the approved amount and the amount to be paid are equal); and
- One service line where part or the entire Medicare approved amount is applied to the part B deductible and/or carrier coinsurance amount.
Once identified, providers should take action to balance bill the beneficiary’s supplemental payer. According to CMS, this problem was fixed as of Feb. 12.
Latest posts by admin aapc (see all)
- Message From Your Region 7 Representatives | October 2018 - October 24, 2018
- Message From Your Region 6 Representatives | October 2018 - October 24, 2018
- Message From Your Region 5 Representatives | October 2018 - October 24, 2018