Pre-enrollment payments would still be allowed under proposed rule

Why This Topic Matters

Medicare enrollment timing can affect when claims may be submitted and how practices manage cash flow, credentialing, and administrative follow-up. The article also highlights concerns about carrier processing delays and the operational impact of revalidation requirements.

Article Sections

1. CMS proposed rule and pre-enrollment payment concerns

   Introduces the proposed Medicare enrollment revalidation rule and the stakeholder concerns it raised about payment timing for services performed before approval of a billing number.

2. CMS clarification of intent

   Summarizes the agency’s clarification that the proposal was not intended to eliminate payment for services furnished before billing approval, and describes the planned clarification in a final rule.

3. MGMA response and carrier processing concerns

   Covers the Medical Group Management Assn.’s reaction, including requests for clearer final-rule language and concerns about carrier accountability and enrollment processing delays.