Part B Insider (Multispecialty) Coding Alert

Published on Mon Jun 19, 2006 PDF

The carriers processed Medicare claims at the new 2006 fee schedule level within a few days after President Bush signed the Deficit Reduction Act, which turned the 4.4 percent physician pay cut into a pay freeze. Here's what you need to know to collect everything you're entitled to.

"We were able to keep to a minimum the number of claims that have to be reprocessed," a Centers for Medicare & Medicaid Services official told a Feb. 16 physician open door forum. You helped out by holding your own claims until after the law went through, he noted.

The carriers have until July 1 to send you the extra money for January's claims. You'll receive an aggregate payment instead of claim-by-claim repayment, but the carrier will include remittance advices that explain the refunds on a claim-by-claim basis. If you have questions about a particular claim, you should contact your carrier, the official said.

Non-participating physicians, or doctors who bill on an unassigned basis, may not have their claims adjusted automatically, the official noted. They should contact their carriers on a case-by-case basis.

You have the right, but are not obligated, to collect extra copayments from your patients for those January claims, the CMS official noted.