decisionhealth Newsletters, Part B News - 2011 Issue 1 (January)
CMS is ‘close’ to completing plans for reprocessing affected 2010 claims
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Article Overview
This article explains a CMS update on reprocessing certain 2010 claims after retroactive fee schedule and payment changes associated with health reform and subsequent legislative action. It discusses the general scope of the affected claims, the operational challenge of running large claim volumes back through payment systems, and the organizations and provider groups pressing for faster action. The piece is relevant to Medicare billing staff, physician practices, and reimbursement professionals tracking historical payment adjustments and administrative implementation timelines.
Why This Topic Matters
Providers with affected 2010 Medicare claims may receive retroactive payment increases, so the timing and scope of CMS reprocessing affects cash flow, claim status review, and payer follow-up. The article also highlights how legislative payment changes can create large-scale administrative reprocessing projects that matter to practices in multiple states and specialties.
What You Will Learn
- How CMS described its progress toward reprocessing affected 2010 claims
- Which broad payment policy changes triggered the reprocessing effort
- Why provider groups were urging quicker implementation
- How the issue affected providers in certain geographic areas
- What legislation funded the reprocessing effort and how it related to Medicare payment policy
Who Should Read This
- Medical coders
- Billing staff
- Revenue cycle professionals
- Physician practice managers
- Compliance staff
- Medicare reimbursement specialists
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