decisionhealth Newsletters, Part B News - 2010 Issue 4 (April)
Some claims affected by lower rate due to last-minute pay fix
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Article Overview
This article covers a Medicare payment issue affecting claims processed around a late legislative pay fix, including which Medicare contractors held claims, which processed at a reduced rate, and the need for automatic reprocessing. It also discusses the broader physician payment environment, including scheduled conversion factor changes, SGR-related concerns, and a possible longer-term policy response. The content is relevant to billing staff, practice managers, and Medicare reimbursement professionals monitoring claim status and payment policy changes.
Why This Topic Matters
It helps practices identify whether claims may have been paid incorrectly during the affected date window and understand the broader Medicare payment policy context that could influence future reimbursement.
Article Sections
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Claims affected by the late pay fix
Discusses the claims processing window, the Medicare contractor response, and the need to review remittances for affected dates of service.
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26.1% cut slated for 2011
Summarizes a projected Medicare payment reduction described in the article and the related physician payment concerns raised by medical associations.
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Still hope for a long-term fix
Covers proposed policy actions in Congress and the possibility of a broader Medicare payment-rate solution.
What You Will Learn
- How a late Medicare pay fix affected claims processing timing
- What types of claims may need reprocessing after a reduced-rate payment
- How the article frames near-term Medicare payment pressures
- What broader policy discussions are underway around Medicare physician payments
Who Should Read This
- Medical billing staff
- Revenue cycle teams
- Practice managers
- Medicare reimbursement specialists
- Physician office administrators
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