tci Medicare Compliance & Reimbursement - 2003 Issue 32

ELECTRONIC CLAIMS EXCEPTIONS FEW AND FAR BETWEEN

Providers should get ready to go electronic with their Medicare claims.When the Health Insurance Portability and Accountability Act transaction rule deadline hits on Oct. 16, if you don't submit your claims electronically, you won't get paid. The Centers for Medicare & Medicaid Services made that clear in an Aug. 15 interim final rule. The rule formally requires that Medicare claims be submitted electronically starting Oct. 16, with only a handful of exceptions. The biggest exception: Small providers and suppliers. CMS defines "small" entities as either a) a provider of services with fewer than 25 full-time equivalent employees, or...

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