by Medical Billing | Oct 4, 2016 | Medicare payment basics
As a general rule, where the contractor receives a late filed claim submitted by a provider or supplier with no explanation attached as to the circumstances surrounding the late filing, the contractor should assume that the provider or supplier accepts responsibility...
by Medical Billing | Sep 30, 2016 | Medicare payment basics
A submission, as defined above, is considered to be a filed claim for purposes of determining timely filing on the date that the submission is received by the appropriate Medicare claims processing contractor. At this point, the submission receives a permanent receipt...
by Medical Billing | Sep 26, 2016 | Medicare payment basics
In general, the start date for determining the 12 month timely filing period is the date of service or “From” date on the claim. For institutional claims (Form CMS-1450, the UB-04 and now the 837 I or its paper equivalent) that include span dates of service (i.e., a...
by Medical Billing | May 1, 2016 | Medicare payment basics
When to file an appeal Once an initial claim determination is made, providers, participating physicians, and other suppliers have the right to appeal. Physicians and other suppliers who do not take assignment on claims have limited appeal rights. Medicare offers five...
by Medical Billing | Nov 7, 2014 | Medicare payment basics
The time for filing a claim will be extended if CMS or one of its contractors determines that a failure to meet the filing deadline is caused by all of the following conditions: (a) At the time the service was furnished the beneficiary was not entitled to Medicare....
