decisionhealth Newsletters, Part B News - 2017 Issue 10 (October)
Mark your calendar to overcome lost charges for liability-billing claims
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Article Overview
This article covers Medicare billing considerations for liability insurance claims, including reporting windows, coordination issues, and timing-based compliance concerns. It is aimed at coders, billers, and practice staff who handle claims where liability coverage may be involved and who need to understand the general Medicare guidance, including a state-specific note for Oregon and references to CMS resources.
Why This Topic Matters
Timing and payer-selection choices in liability cases can affect whether a practice gets paid at all. Understanding the general Medicare framework helps billing staff reduce avoidable denials and missed filing deadlines.
Article Sections
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Liability-billing overview
Introduces the billing scenario and the kinds of reimbursement challenges that can arise when liability coverage may apply. Summarizes why these claims require special attention from practice staff.
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1. Mark the beginning and end of the “promptly period” to set your timeline.
Discusses the Medicare timing window associated with liability claims and how it affects claim handling. Includes general CMS guidance on the period and the options available after it ends.
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2. Consider going with the guaranteed option.
Reviews the general choice between pursuing liability coverage and turning to Medicare. Explains the practical reimbursement tradeoffs at a high level.
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3. Stay within the boundaries of the timely filing period.
Covers Medicare filing deadlines after the earlier liability-related window has passed. Notes the importance of the standard Medicare timely filing period.
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4. Drop your liability claims after one year to stay compliant with Medicare.
Addresses the separate calendar-based limit tied to Medicare compliance and liability collection efforts. Focuses on the general requirement to stop pursuing the claim after the deadline.
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5. Heed stricter requirements if you practice in Oregon.
Summarizes the state-specific Medicare liability-billing note for Oregon. Highlights that the article identifies different handling considerations for practices in that state.
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Resources
Lists CMS-related reference materials and manuals cited by the article for further reading.
What You Will Learn
- How Medicare liability-billing timing windows affect claim handling
- What general issues can arise when liability coverage may be involved
- How Medicare timely filing considerations fit into liability claims
- Why state-specific differences may matter for certain practices
- Which CMS resources are referenced for additional guidance
Who Should Read This
- Medical coders
- Medical billers
- Practice managers
- Physician office staff
- Revenue cycle staff
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