decisionhealth Newsletters, Coder Pink Sheets - 2006 Issue 3 (March)
If your fees are set at Medicare allowable or less, you may need to resubmit claims filed early in 06
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Article Overview
This article is for medical coders, billing staff, and practice managers who need to understand how early-2006 Medicare fee schedule updates interacted with claim filing and resubmission. It discusses the impact of the Deficit Reduction Act, carrier reprocessing behavior, fee schedule and payment update issues, and a related Medicare payment timing matter that affected providers during 2006.
Why This Topic Matters
Providers with fees at or below Medicare allowable amounts could be affected differently than those billed above the updated schedule, making it important to know when claims may need review or redetermination. The article also highlights timing and administrative changes that could affect cash flow and claim management.
What You Will Learn
- How early-2006 Medicare fee schedule changes affected previously filed claims
- Why some claims may need redetermination rather than automatic reprocessing
- How the Deficit Reduction Act influenced Medicare payment updates and provider participation
- What payment timing changes were expected to affect Medicare reimbursements in late 2006
Who Should Read This
- Medical coders
- Billing staff
- Practice managers
- Physician office administrators
- Revenue cycle professionals
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