Claim Status Request and Response CMS Guidelines Claim Status Request and Response: Providers have a number of options to obtain claim status Information from Medicare Administrative Contractors (MACs): Providers can enter data via the Interactive Voice Response (IVR) telephone systems operated by the MACs. Providers can submit claim status inquiries via the Medicare Administrative Contractors’ provider … Read More →
Electronic Health Care Claims Submission Notes Electronic Health Care Claims: Claims may be electronically submitted to a Medicare Administrative Contractor (MAC) from a provider 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 category area … Read More →
ASCA Self Assessment Basic Requirements ASCA Self Assessment guidelines refer to the Administrative Simplification Compliance Act (ASCA) that prohibits payment of initial health care claims not sent electronically except in limited situations: Small Provider Claims: The word “provider” is being used generically here to refer to physicians, suppliers, and other providers of health care services. Providers … Read More →
ASCA (Administrative Simplification Compliance Act) Enforcement Reviews ASCA (Administrative Simplification Compliance Act) prohibits payment of services or supplies that a provider did not bill to Medicare electronically. “Providers” is used in a generic sense here and refers equally to physicians, suppliers, and other health care providers. Providers are required to self-assess to determine whether they … Read More →