HCR: New Timely Filing Requirements for Medicare FFS Claims

News of how health care reform will affect Medicare providers continues to trickle in. Of late, a First Coast Service Options (FSCO) online post notifies providers that one of the bills President Obama signed into law in March amended the period for filing Medicare fee-for-service (FFS) claims.

Section 6404 of the Patient Protection and Affordable Care Act (PPACA) amends the timely filing requirements to reduce the maximum time for submission of all Medicare FFS claims from three years to one calendar year after the date of service.

Under the new law, claims for services furnished on or after Jan. 1, 2010 must be filed within one calendar year after the date of service. In addition, Section 6404 mandates that claims for services furnished before Jan. 1, 2010 must be filed no later than Dec. 31, 2010.

According to FCSO, claims with dates of service Oct. 1, 2009 through Dec. 31, 2009 must be submitted by Dec. 31, 2010. For claims with dates of service before Oct. 1, 2009, providers should follow pre-PPACA timely filing rules.

4 Responses to “HCR: New Timely Filing Requirements for Medicare FFS Claims”

  1. Carmon Mathews says:

    Does the new requirement include Part A consolidated billing?

  2. Michelle Green says:

    So, does that mean if a services were provided on February 1, 2010, the claim must be submitted by February 1, 2011? Or, should the claim be submitted by December 31, 2011?

    The “within one calendar year” language is confusing me because I define a calendar year as “January 1 through December 31.”

  3. Melissa Farley says:

    I take it to mean that services provided on February 1, 2010 would need to be submitted no later than February 1, 2011.

  4. Tasha Ge says:

    It says within one calender year after the date of service so its not from January 1, 2010 to January 1, 2011 if the claim date of service was December 29, 2009. Bottomline filing claims should not take that long at all but due to so many insurance companies denying for timely filing I see this as a great ruling.

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