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ASCA Waiver Application Guidelines For Providers ASCA Waiver Application guidelines describe some situations when this electronic billing requirement could be waived for some or all claims, but a provider must obtain Medicare pre-approval to submit paper claims in these situations: Any situation where a provider can demonstrate that the applicable adopted HIPAA claim standard does not Read More →

Claim Status Request

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 →

Medicare EDI

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

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 →