decisionhealth Newsletters, Part B News - 2010 Issue 4 (April)
CMS finalizes timely claims change
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Article Overview
This article covers CMS’s finalization of a reduced Medicare timely filing period under PPACA, with emphasis on how the change affects claims submission workflows, secondary payer situations, and insurance verification processes. It is relevant to billing staff, coders, practice managers, and revenue cycle professionals who need to understand filing deadlines and the administrative risks of delayed claims. The article also notes the transition timing for older dates of service and the possibility of future rulemaking changes.
Why This Topic Matters
Shorter filing windows can affect reimbursement, denied claims, and payer coordination, especially when Medicare is secondary or coverage information is incomplete. Understanding the change helps practices reduce untimely filing risk and maintain cleaner billing processes.
Article Sections
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Claims filing timeframe change
Explains the revised Medicare claims filing period and the general policy change announced by CMS. The section places the update in the context of federal health reform.
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Operational impact for practices
Discusses how the shorter timeframe can affect claim handling in situations involving multiple payers, insurance verification, and delayed coordination between primary and secondary coverage.
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Effective date and transition timing
Summarizes when the change took effect and how older dates of service are handled during the transition period. It also mentions the potential for future rulemaking changes.
What You Will Learn
- How CMS changed the Medicare timely filing period
- Why payer coordination can become more difficult under a shorter deadline
- What administrative practices may help reduce untimely filing risk
- How the transition timing applies to claims for earlier dates of service
Who Should Read This
- Medical coders
- Billing staff
- Revenue cycle professionals
- Practice managers
- Healthcare consultants
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