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CollaborateMD believes in keeping our customers informed of pertinent issues which may affect your business. Please read the following bulletin from Noridian Medicare Part B, which affects these payers:

CPID 2454 SD Medicare
CPID 2466 WY Medicare
CPID 1459 OR Medicare
CPID 2458 UT Medicare
CPID 2453 ND Medicare
CPID 1455 AK Medicare
CPID 7400 MT Medicare
CPID 1456 AZ Medicare
CPID 1462 WA Medicare

Action Required: Please be aware of the following information:

HOLDING CLAIMS FOR SERVICES PAID UNDER THE 2012 MPFS
The negative update under current law for the 2012 Medicare Physician Fee Schedule (MPFS) was scheduled to take effect on January 1, 2012. Consequently, as on numerous occasions in the past, CMS will instruct its Medicare claims administration contractors to hold claims containing 2012 services paid under the Medicare Physician Fee Schedule for the first 10 business days of January (i.e., January 1, 2012, through January 17, 2012). The hold should have minimal impact on provider cash flow because, under current law, clean electronic claims are not paid sooner than 14 calendar days (29 days for paper claims) after the date of receipt.

MPFS claims for services rendered on or before December 31, 2011, are unaffected by the 2012 claims hold and will be processed and paid under normal procedures and time frames.

The Administration has stated their disappointment that Congress has failed to pass a solution to eliminate the sustainable growth rate (SGR) formula-driven cuts, and has put payments for health care for Medicare beneficiaries at risk. They continue to urge Congress to take action to ensure these cuts do not take effect.

CMS will provide notice on or before January 11, 2012, with more information about the status of Congressional action to avert the negative update and next steps regarding the claims hold.

If you have any questions please contact CollaborateMD Client Services at 1-888-348-8457, Option 2.

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