I have been using the services of the staff of MRC for several years and have been pleased with their professionalism combined with caring and helpful attitudes. When opportunities came to consider changing to other billing companies, I chose instead to stay with this staff because I trusted them and felt they were looking out for my best interest.
-Dr. Hazelbaker
Internal Medicine
I've been assosiated with Ashley and her MRC team for approximately four years. The best thing that I can say is that I don't have to worry about whether my billing is completed and whether it is done right. I've experienced excellent collections and would recommend the MRC team to anyone.
-Dr. Harold L Dyer
Pulmonary Specialist |
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On-going Medicare claims processing issues - Post SGR fix
July 27, 2010
There have been some postings on the HBMA listserve and direct contacts with the National Office regarding some on-going problems billing companies and their physician clients are having relative to the processing of certain Medicare claims. It appears that some Medicare contractors are having more difficulty than others adjusting their computer systems to reflect the SGR "fix" and related issues.
In response to these questions and concerns, HBMA staff contacted the CMS National Office staff responsible for overseeing the Medicare Contractors to see if they were aware of these problems and see what actions CMS can/would take to address these problems.
According to the CMS staff, the lengthy delay in getting Congressional approval for rescinding the SGR cut; the retroactive application of the restoration of higher payments and the inclusion of a 2.2% increase in payments on those claims presented particular administrative and technological challenges for Medicare's contractors.
CMS told HBMA that it took some coordination to release claims from the claims hold that CMS initiated as Congress worked to pass legislation that allowed for a positive reimbursement level.
CMS contractors were directed to begin releasing claims in late June, at the same time that they were simultaneously adjusting claims that were paid at the lower (SGR cut) rate. The Medicare contractors should have completed the adjustment processing nationally on July 9 and all of the claims that had been held, pending fee schedule update, should have been released for processing this week (July 19th).
CMS acknowledges that some Contractors did a better job of handling this situation than others and as a result, there was some variation across the country in terms of processing. There were also some delays nationally because of limits on the processing capacity at CMS's data centers. The holding of millions of claims strained the computer capacity of several contractors and this also contributed to the problems.
CMS believes that things should smooth out shortly but if we become aware of problems, CMS staff has asked HBMA to bring these situations to their attention.
If your clients are continuing to experience SGR related delays in claims processing, please contact the HBMA National Office and we will bring these situations to the attention of the appropriate staff in the CMS National Office.
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