+DDE providers receiving RC 32212 In Error - (UPDATED 06/26/08) ( click for details)
On 6/3/08 a FISS problem was identified that impacted DDE providers. The rate amounts were being removed upon claim entry causing claims to error with Reason Code 32212. Providers were advised of a workaround to use until the problem could be corrected. The programming was installed into Production on 6/23/08 to correct the problem and confirmed. Providers should now no longer need to use the workaround when entering new claims. If you are correcting claims currently in the RTP File, you may still need to use the workaround, as the original claims were entered before the correction was installed.
+Attention Part A EDI Customers (07/03/08) ( click for details)
Due to a technical problem at the Enterprise Data Center (EDC), the delivery of the IG Edit reports and the ANSI ASC X12N 835 Electronic Remittance Advice(ERA) dated July 2, 2008 are delayed and not yet available. A follow-up listserv will be sent when the reports and ERA files are available. We apologize for any inconvenience.
- July 03, 2008
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CWF July 4, 2008 Holiday Schedule The Southwest/Mid-Atlantic/Great Western/Keystone/Northeast/South Hosts will be closed Friday, July 4, 2008, in observance of Independence Day. HIMR and NDM will be available; however, there will be no staff onsite. Any files received will be processed the following morning, July 5, 2008 and returned that day. MLN Matters Articles from CMS
- July 02, 2008
CMS HOLDING OF JULY CLAIMS “The following Questions and Answers apply to the recent decision by the Centers for Medicare & Medicare Services to hold claims paid under the Medicare physician fee schedule (MPFS) up to 10 business days that contain July 2008 dates of service. -
The exceptions to outpatient therapy caps expire on June 30, 2008. Outpatient therapy service providers should not submit claims with the KX modifier for services furnished on or after July 1, 2008. To the extent possible, CMS is working with Congress, health care providers, and the beneficiary community to avoid disruption in the delivery of health care services and payment of outpatient physical therapy, occupational therapy and speech-language pathology claims for services furnished by physicians, non-physician practitioners, and therapists paid under the physician fee schedule, beginning July 1.
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+Denied Claims - (UPDATED 07/03/08) ( click for details)
At the time of the system problem, if you had an appeal pending for a claim that had previously been denied, the impacts to you would be different than those where the claim denied and is being reprocess for payment. Providers who expected to receive payment for the appealed services instead received a refund requests. Individual contacts are being made to those impacted providers to explain the actions that need to be taken. Once again, we apologize for the inconvenience this has caused.
+Attention Part B EDI Customers (07/03/08) ( click for details)
Due to a technical problem at the Enterprise Data Center (EDC), the delivery of the MCS Edit reports and the ANSI ASC X12N 835 Electronic Remittance Advice(ERA) dated July 2, 2008 are delayed and not yet available. A follow-up listserv will be sent when the reports and ERAs are available. We apologize for any inconvenience.
- July 03, 2008
Reminder - 2008 Physician Quality Reporting Initiative (PQRI) National Provider Conference Call with Question & Answer Session The Centers for Medicare & Medicaid Services’ (CMS) Provider Communications Group will host the fifth in a series of national provider conference calls on the 2008 Physician Quality Reporting Initiative (PQRI). Date: July 9, 2008
Conference Title: 2008 Physician Quality Reporting Initiative National Provider Call
Time: 3:30-5:00 EDT Registration will close at 3:30 p.m. EDT on July 8, 2008, or when available space has been filled. No exceptions will be made, so please be sure to register prior to this time. To register for the call participants - click here. CWF July 4, 2008 Holiday Schedule
The Southwest/Mid-Atlantic/Great Western/Keystone/Northeast/South Hosts will be closed Friday, July 4, 2008, in observance of Independence Day. HIMR and NDM will be available; however, there will be no staff onsite.
Any files received will be processed the following morning, July 5, 2008 and returned that day. MLN Matters Articles from CMS
- July 02, 2008
CMS HOLDING OF JULY CLAIMS “The following Questions and Answers apply to the recent decision by the Centers for Medicare & Medicare Services to hold claims paid under the Medicare physician fee schedule (MPFS) up to 10 business days that contain July 2008 dates of service. -
The exceptions to outpatient therapy caps expire on June 30, 2008. Outpatient therapy service providers should not submit claims with the KX modifier for services furnished on or after July 1, 2008. To the extent possible, CMS is working with Congress, health care providers, and the beneficiary community to avoid disruption in the delivery of health care services and payment of outpatient physical therapy, occupational therapy and speech-language pathology claims for services furnished by physicians, non-physician practitioners, and therapists paid under the physician fee schedule, beginning July 1.
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