HIPAA Contingency Basic Guidelines HIPAA Contingency plan was implemented by Medicare on October 16, 2003. HIPAA Contingency allowed providers and other electronic billers to temporarily continue to send pre-HIPAA electronic format claims, claim status requests, and beneficiary eligibility requests, and for CMS to continue temporarily sending remittance advice, claim status responses, beneficiary eligibility responses, and coordination … Read More →
Professional Claim Form Basics Professional Claim Form may be electronically submitted to a Medicare carrier, Durable Medical Equipment Medicare Administrative Contractor (DMEMAC), or A/B MAC from a provider’s office using a computer with software that meets electronic filing requirements as established by the HIPAA claim standard and by meeting CMS requirements contained in the provider enrollment & certification … Read More →
Institutional Paper Claim Form Guidelines Institutional Paper Claim Form (CMS-1450 form), aka UB-04 at present, can be used by an institutional provider to bill a Medicare fiscal intermediary (FI) when a provider qualifies for a waiver from the Administrative Simplification Compliance Act (ASCA) requirement for electronic submission of claims. It is also used for billing … Read More →
Electronic Claims Attachments: Supplemental Medical Documents Electronic Claims Attachments are supplemental documents providing additional medical information to the claims processor that cannot be accommodated within the claim format. Common attachments are Certificates of Medical Necessity (CMNs), discharge summaries and operative reports. They are sent to the Durable Medical Equipment Medicare Administrative Contractor (DME MAC) and/or A/B MAC with … Read More →