MDS Alert
MDS & Billing News To Use
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CMS is giving providers a HIPAA break ... Good news on the billing front: CMS will continue to process Medicare claims that don't meet HIPAA-required electronic code and transaction standards after the Oct. 16 compliance deadline, the agency announced on Sept. 23. "Implementing this contingency plan moves us toward the dual goals of achieving HIPAA compliance while not disrupting providers' cash flow and operations," said CMS Administrator Tom Scully.
CMS decided providers needed the breathing room after statistics showed an unacceptably low rate of compliant claims being submitted as the deadline approached. "Medicare is able to process HIPAA-compliant transactions," said Tom Grissom, director of CMS' Center for Medicare Management, "but we need to work with our trading partners to increase the percentage of claims in production."
Even though CMS has not specified a date when it will no longer accept noncompliant claims, nursing facilities need to make sure their software is compliant, says Steve Jones, a CPA with the Clearwater, FL office of Moore Stephens Lovelace. "That includes billing software and MDS and health records transmitted electronically."
CMS is going paperless. Starting Oct. 1, 2003, the Centers for Medicare & Medicaid Services will transition from a paper-based manual system to a Web-based one. The process includes the streamlining, updating and consolidating of CMS' various program instructions into an electronic Web-based manual system for all users. The new system is called the online CMS Manual System and is located at www.cms.hhs.gov/manuals.
The new online CMS Manual System will be organized by functional area, (e.g., eligibility, entitlement, claims processing, benefit policy and program integrity).
Looking for a good review of SNF consolidated billing for MDS and billing staff? Check out a recent provider education article on guidelines for SNF consolidated billing, published by the Medicare Learning Network (www.cms.hhs.gov/medlearn/articlesnf.pdf). The article discusses the background of the SNF consolidated billing regulation; services, supplies, and facilities included and excluded from SNF consolidated billing; professional and technical components of diagnostic tests; and ambulance services. In addition, the article includes information resources for SNF consolidated billing.
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