Medicare Compliance & Reimbursement

Credentialing:

CMS Clarifies New 30-Day Retrospective Billing Rule

Count 30 days back from application date, CMS says. CMS has cut its retrospective billing rule from 27 months to 30 days, but the new rule may not be so bad. According to the 2009 Medicare Physician Fee Schedule, you'll be able to retroactively bill Medicare for services your physician rendered up to 30 days prior to the date of filing a Medicare enrollment application that a Medicare contractor subsequently approves. You have 30 days from the day you submitted the enrollment application to the Medicare carrier and the carrier receives your signed certification via mail, if you're filing via PECOS. If you file via paper application, the filing date is the day the carrier receives your application. CMS concurs: During a Jan. 13 CMS open door forum, Jim Bossenmeyer of CMS' office of financial management said that the effective date of billing is the later of either the date of [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Medicare Compliance & Reimbursement

View All