CMS unsure when claims rejection will start after ordering, referring deadline

Why This Topic Matters

Organizations that bill Medicare need to understand timing issues and administrative changes that may affect whether claims are accepted or rejected. The article also highlights enrollment workflow concerns and system improvement discussions that can affect provider enrollment operations.

Article Sections

1. PECOS deadline and claims processing timing

   Overview of the ordering/referring deadline, CMS uncertainty about claims-processing edits, and the role of PECOS enrollment status in Medicare billing operations.

2. CMS ponders changes to web-based PECOS

   Summary of a CMS forum with contractors and stakeholders focused on the online enrollment experience and suggested improvements to the web-based system.

3. CMS enrollment department changes

   Brief coverage of leadership and organizational changes within the CMS enrollment function and related program integrity groups.