tci Medicare Compliance & Reimbursement - 2018 Issue 10

Reader Question: Timely Claims Get Paid — Late Claims Do Not

Question: We had a problem with a claim and didn't get it filed with Medicare until over a year after the procedure date. Will this get paid? SuperCoder Subscriber Answer: No. Medicare gives you only 12 months to file a claim, and exceeding this limit will cause instant denials. The time period for filing Medicare fee-for-service claims was amended as part of the Patient Protection and Affordable Care Act (PPACA). Under this law, the claims for services furnished on or after Jan. 1, 2010, must be filed within one calendar year after the date of service. Medicare requires all...

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