Six-week CMS payment snafu may have cost you thousands of dollars

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Note:  The following article synopsis was NOT provided by HCPro. It was created by Find-A-Code/innoviHealth.

Article Overview

This article covers a CMS billing glitch that affected the automatic crossover of certain Medicare Part B claims to secondary payers during a specific early-2010 time period. It is relevant to billing staff, practice managers, and revenue cycle teams responsible for reconciling remittance advice, EOBs, and secondary payer payments. The article focuses on the general steps used to identify potentially affected claims, check whether payment was already received, and pursue follow-up with the secondary payer when needed.

Why This Topic Matters

The issue could create unexpected accounts receivable shortfalls if claims were not forwarded correctly even though paperwork suggested otherwise. Practices needed to review affected claims and coordinate with secondary payers to recover money that might otherwise have been overlooked.

Article Sections

  1. CMS billing glitch and affected claims

    Explains the reported claims-processing issue, the time period involved, and the general type of Medicare Part B claims that may have been impacted.

  2. How to identify potentially affected claims

    Describes the broad claim characteristics used to narrow down which remittance advice records may need review.

  3. How to recover missing payments

    Covers the general follow-up process for checking whether payment was already received and submitting a claim to the secondary payer if needed.

What You Will Learn

  • What type of CMS processing issue the article addresses
  • How the affected claims were generally identified
  • What billing staff needed to review before pursuing secondary payer payment
  • What administrative follow-up was discussed for missing reimbursement

Who Should Read This

  • Medical billing staff
  • Practice managers
  • Revenue cycle personnel
  • Medicare billing specialists

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