tci Medicare Compliance & Reimbursement - 2018 Issue 17

Industry Note: Know this Medicare Deadline Loophole

If you run behind on submitting your documentation for a claim under medical review, you may get a reprieve — depending on who your MAC is. Medicare regulations require that “when the Medicare Administrative Contractor (MAC) requests documentation for prepayment or postpayment review, the provider must submit the documentation within 45 calendar days, or the claim shall be denied,” HHH MAC Palmetto GBA says on its website. However: “If the MAC receives the requested information after a denial has been issued for non-receipt of requested records, the MAC has the discretion to reopen the claim,&rdquo...

To read the full article, sign in and subscribe to tci Medicare Compliance & Reimbursement.


Keep pace with evolving Medicare regulations — and onboard your team — with timely analysis of critical updates interpreted in an easy-to-follow, easy-to-apply format. Your subscription to TCI's Medicare Compliance & Reimbursement Alert will equip you to navigate code and guideline changes, CCI edits, and revisions to modifiers, payer policies, the fee schedule, OIG target areas, and more.

  • Current newsletters added each month
  • Fully searchable archives - over 4200 articles
  • ALL years/issues back to 2003 organized by year and issue
  • Codes mentioned in articles are linked to Code Information pages
  • Code Information pages link back to related articles
Access to this feature is available in the following products:
  • tci Medicare Compliance & Reimbursement +Archives

demo
request yours today
 subscribe
start today
 newsletter
free subscription

Thank you for choosing Find-A-Code, please Sign In to remove ads.