tci Medicare Compliance & Reimbursement - 2009 Issue 2
Credentialing: CMS Clarifies New 30-Day Retrospective Billing Rule
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Article Overview
This article covers CMS clarification of a shortened Medicare retrospective billing period and how the timing is tied to enrollment application filing and practice start dates. It is aimed at physicians, practice managers, credentialing staff, and billing professionals who need to understand Medicare enrollment timing, carrier processing, and when the rule takes effect for Medicare contractors.
Why This Topic Matters
The update affects when practices can begin billing Medicare for services furnished before enrollment approval, which can influence revenue cycle timing and credentialing workflows. It also notes implementation timing and contractor guidance issues that may affect compliance planning.
What You Will Learn
- How CMS describes the updated retrospective billing period for Medicare enrollment
- How application filing timing relates to billing effective dates
- What the article says about implementation timing and contractor guidance
- Why credentialing and enrollment staff need to track practice start dates and application submission dates
Who Should Read This
- Physicians
- Practice managers
- Credentialing staff
- Billing and reimbursement professionals
- Healthcare administrators
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